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  • Title: [A case of pontine infarction presenting with conjugate deviation and unilateral conjugate gaze palsy].
    Author: Uemura J, Shibazaki K, Inoue T, Iguchi Y, Kimura K.
    Journal: Rinsho Shinkeigaku; 2007 May; 47(5):231-3. PubMed ID: 17585606.
    Abstract:
    We reported a case of pontine infarction presenting with conjugate deviation and unilateral conjugate gaze palsy. A 75-year-old man was admitted to our hospital because of vomiting. On the day of admission, his neurological findings showed only conjugate deviation to the right without consciousness disturbance, hemispatial neglect, and hemiparesis. On day 5 after admission, the conjugate deviation to the right disappeared, but he could not gaze left with either of his eyes. The pathological lesions, therefore, were considered to be a unilateral paramedian pontine reticular formation (PPRF) and abducens nucleus. Diffusion-weighted imaging (DWI) on day 2 revealed a small high intensity lesion in the left paramedian pontine tegmentum. A diagnosis of brain infarction was made. A Holter electrocardiogram and electroencephalogram were normal. Transesophageal echocardiography disclosed ulcerated plaque in the aortic arch. This is the first case of pontine infarction presenting with conjugate deviation in which unilateral conjugate gaze palsy and DWI could confirm the pathological lesion.
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