Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology Pub Date : 2025-02-07 DOI:10.1186/s12883-025-04021-x

Shangpei Wang, Yajie Cai, Xiaosan Wu, Sunhong Yan, Longsheng Wang

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引用次数: 0

Abstract

Background: Oculomotor nerve palsy is a common neurological presentation in daily practice.

Case presentation: A 55-year-old man presented with a 3-h history of diplopia and drooping of his bilateral especially left eyelids. Examination revealed an isolated oculomotor nerve palsy consisting of left medial rectus, inferior oblique, superior rectus, inferior rectus with intact pupillary reflexes and bilateral especially left superior palpebral levator. Conventional diffusion weighted imaging (DWI) of the brain showed a suspicious restriction in the left midbrain periaqueductal region. If the clinical symptomatology indicates a lesion in the midbrain, of which a high signal intensity was encountered from neurologically healthy older adults, the limited spatial resolution of conventional axial DWI is an enormous disadvantage. Zonally magnified oblique multislice (ZOOM) DWI correlated with apparent diffusion coefficient map providing higher accuracy for accurate diagnosis can identify signal alterations of mesencephalic interpeduncle area.

Conclusions: This is a rare presentation of isolated oculomotor nerve palsy due to pure mesencephalic infarction especially verified by ZOOM DWI.

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ZOOM DWI诊断中脑梗死致孤立性动眼神经麻痹。

背景：动眼神经麻痹是日常实践中常见的神经学表现。病例介绍：55岁男性，复视3小时，双侧特别是左眼睑下垂。检查发现孤立性动眼神经麻痹，包括左内侧直肌、下斜肌、上直肌、下直肌，瞳孔反射完整，双侧尤其是左上睑提肌。常规脑弥散加权成像（DWI）显示左侧中脑导水管周围区可疑受限。如果临床症状显示中脑病变，且神经系统健康的老年人在中脑病变中获得高信号强度，则传统轴向DWI有限的空间分辨率是一个巨大的缺点。纬向放大倾斜多层螺旋（ZOOM） DWI与表观扩散系数图相关，诊断精度更高，可准确识别中脑脑柄间区信号改变。结论：这是一种罕见的单纯中脑梗死引起的孤立性动眼神经麻痹，特别是ZOOM DWI证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Neurology 医学-临床神经学

CiteScore

4.20

自引率

0.00%

发文量

428

审稿时长

3-8 weeks

期刊介绍： BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.