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Multiple etiologies may cause oculomotor nerve palsies. Identification of different etiologies is very important for subsequent treatment. Midbrain infarction is a rare cause of oculomotor nerve palsy. We herein present a case of isolated unilateral oculomotor paresis caused by pure midbrain infarction. Her pupillary sphincter and inferior rectus muscles were selectively spared. The symptoms were completely relieved after two months of antiplatelet therapy. We proposed that fibers from Edinger-Westphal nucleus and inferior rectus nucleus do not course through the paramedian area of the midbrain. Our report adds to the understanding of fascicles arrangement in the midbrain.
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http://dx.doi.org/10.1080/00207454.2023.2264479 | DOI Listing |
Neuroradiol J
August 2025
Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", Radiology Unit 1, Italy.
Artery of Percheron (AOP) infarction is a rare form of ischemic stroke resulting from the occlusion of a single arterial trunk that supplies both sides of the paramedian thalamus and the midbrain. Its occlusion can lead to bilateral and symmetrical infarctions of the paramedian thalami, and occasionally, the midbrain. Due to its atypical presentation, this condition is often diagnosed late.
View Article and Find Full Text PDFBMC Neurol
August 2025
Department of Neurology, Peking University First Hospital, Beijing, China.
Background And Purpose: Heterozygous HTRA1-related cerebral small vessel disease (hHTRA1-CSVD) presents diagnostic challenges due to its clinical and imaging similarities with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and sporadic cerebral small vessel disease (CSVD). Recently, the "chocolate chip sign" around the midbrain has been proposed as a potential imaging marker for hHTRA1-CSVD. However, the diagnostic value of similar findings around the pons remains unclear.
View Article and Find Full Text PDFBrain Sci
July 2025
Department of Neurology, Justus-Liebig-University, 35392 Giessen, Germany.
Brainstem ischemic strokes comprise 10% of ischemic strokes and are challenging to diagnose due to small lesion size and complex presentations. Diffusion-weighted imaging (DWI) is crucial for detecting ischemia, yet it can miss small lesions, especially when only axial slices are employed. This study investigated whether ischemic lesions visible in a single imaging plane correspond to smaller volumes and whether coronal DWI enhances detection compared to axial DWI alone.
View Article and Find Full Text PDFAnn Med Surg (Lond)
July 2025
Department of Neurosurgery, College of medical sciences,Bharatpur 44200, Nepal.
The artery of Percheron (AOP) infarction is a rare vascular condition and a pattern of ischemia where a single arterial trunk supplies blood to the rostral midbrain and paramedian thalamic areas, causing neurological deficits. Due to its rarity and atypical presentation, AOP infarction is frequently overlooked in initial assessments, particularly on computed tomography (CT) scans. In addition, different types of AOP infarction have been identified, and it is shown that there can be four significant distinct types of this disease, which may manifest some different symptoms and have various vascular alterations.
View Article and Find Full Text PDFNeurol India
August 2025
Department of Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.