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Vertical one-and-a-half syndrome overlapping with pupillary abnormality. Acta Neurol Belg 2023:10.1007/s13760-023-02177-2. [PMID: 36640253 DOI: 10.1007/s13760-023-02177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
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Gonçalves DB, Barreira RP, Torres TZM, Correa BM, Rossette VM, Marques TDC, Costa FP, Dutra BG, Júnior EM, Moreira ÁR, Dos Santos JCC. Vertical one-and-a-half syndrome in a patient with pecheron artery ischemia: A case report. Radiol Case Rep 2021; 16:3908-3910. [PMID: 34703516 PMCID: PMC8526492 DOI: 10.1016/j.radcr.2021.09.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
Vertical one-and-a-half syndrome (VOHS) is an uncommon presentation resulting from a unilateral thalamomesencephalic stroke with involvement of the rostral interstitial nucleus of the medial longitudinal fasciculus and posterior commissure. The artery of Percheron (aPe) is a branch of the posterior cerebral artery (PCA) and it is a variant that arises as a solitary trunk supplying both medial thalami and upper midbrain. A 78-year-old female patient, presented at the hospital emergency with approximately 12 hours of sudden onset of diplopia, associated with dizziness. Neurological exam revealed torsional nystagmus associated with bilateral upgaze palsy with limitation of infraduction on the left. We describe a rare case of VOHS associated with ischemic alterations at the MRI suggesting an aPe impairment. The conjugate gaze control lies anatomically at the midbrain at the central nervous system (CNS). This report describes a rare type of VOHS and brings a new insight on a possible aPe topography possibly causing this clinical presentation.
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Affiliation(s)
- Daniel Buzaglo Gonçalves
- Universidade Federal do Amazonas (UFAM), Rua Afonso Pena, 1053 - Centro, Manaus, Amazonas, Brazil
| | | | | | | | | | | | | | - Bruna Guimarães Dutra
- Universidade Federal do Amazonas (UFAM), Rua Afonso Pena, 1053 - Centro, Manaus, Amazonas, Brazil
| | - Euldes Mendes Júnior
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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