Case Report: How May Ocular Alignment Guide the Topography of the Lesion
Cucchiara María Camila
Hospital Provincial del Centenario, Department of Neurology, Universidad Nacional de Rosario (UNR), Argentina.
Zalazar Guillermo *
Fundacion San Lucas, Rosario, Argentina.
Bernaba Elisabet
Hospital Provincial del Centenario, Department of Neurology, Universidad Nacional de Rosario (UNR), Argentina.
Laura Ortube
Fundacion San Lucas, Rosario, Argentina.
Sandra Barbosa
Neuro-ophthalmology Service, Hospital Provincial del Centenario, Department of Ophtalmology, Universidad Nacional de Rosario (UNR), Argentina.
Sergio Carmona
Neuro-ophthalmology Service, Hospital Provincial del Centenario, Department of Ophtalmology, Universidad Nacional de Rosario (UNR), Argentina.
*Author to whom correspondence should be addressed.
Abstract
A 58 years old pale patient of hypertension, with a history of left thalamic hemorrhagic stroke (2010), had a sudden onset and progressive evolution that began a few hours ago, characterized by right palpebral ptosis and diplopía. The condition was followed by left faciobrachiocrural paresis, difficulty to maintain the sitting or standing and sensory impairment. The patient was found with conditions, such as, Eye-opening upon request, Disoriented in time, Lack of verbal initiative, Central left facial palsy, Left brachiocrural paresis (4/5), Imposibility to maintain a seating or standing position and Bilateral Babinski. The symptomps can only be explained by a biliateral thalamic lesion, although unilateral lesions can occasionally cause similar symptoms.
Keywords: Ocular alignment, HINTS, thalamic lesion, gait disturbance