Research in Vestibular Science

Case Reports

Rare Neuro-Ophthalmological Manifestations of Focal Midbrain Infarction: Joong-Goo Kim, Ji-Hoon Kang, Jay Chol Choi, Hong Jun Kim, Chul-Hoo Kang; Res Vestib Sci. 2021;20(2):58-63. Published online June 14, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.2.58

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Because numerous important nuclei and white matter tracts are concentrated in the narrow midbrain, the tiny lesion can result in various symptoms. The anatomy of the neural network and related structures in the midbrain is complex. The most frequent clinical manifestation of lesions involving the midbrain is an eye movement disorder associated with a nuclear or fascicular origin. We have described patients with acute midbrain stroke, characterized by rare neuro-ophthalmologic manifestations, which neurologists should consider during diagnostic investigations. Case 1 showed internuclear ophthalmoplegia with Horner syndrome. In case 2 showed isolated oculomotor palsy. The third patient presented Parinaud syndrome with an unusual lesion location. Notably, patients with midbrain infarction may present with specific signs and symptoms that are compatible with mesencephalic localization. The isolated or combined neuro-ophthalmologic signs and symptoms should be interpreted in the complex anatomical context described here and investigated by immediate brainstem neuroimaging analyses and careful neurologic examinations.

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A Improved Case of Post Cerebral Infarction Dizziness and Gait Discomfort after Treated with Korean Medicine Treatment and Vestibular Rehabilitation Practice
Hongmin Chu, Hyeon-Seo Lim, Kwangho Kim, Young-Ung Lee, Kyungtae Park, Jongwon Jang, Ho-sun Ryu, Su-hak Kim, Cheol-hyun Kim, Sangkwan Lee, Kang-keyng Sung
Journal of Korean Medicine Rehabilitation.2020; 30(4): 179. CrossRef

Vertical One-and-a-Half Syndrome Accompanying Contralateral Abduction and Incomplete Depression Palsy Due to Thalamo-Mesencephalic Infarction: Won Gu Lee, Meyung Kug Kim, Bong Goo Yoo; Res Vestib Sci. 2017;16(4):151-155. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.151

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Abstract PDF: Vertical gaze palsy is usually associated with lesions of the rostral midbrain and thalamo-mesencephalic junction. The rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF), the interstitial nucleus of Cajal, and the posterior commissure located in the midbrain are the critical area in supranuclear control of vertical eye movements. We describe a case of vertical one-and-a-half syndrome accompanying contralateral abduction and incomplete depression palsy due to thalamo-mesencephalic infarction. These vertical eye movement abnormalities are presumed to be caused by damage to the ipsilateral riMLF, interstitial nucleus of Cajal, and oculomotor fascicles.

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