[Divergence paralysis due to a lesion of the lateral tegmentum of the midbrain caused by thalamic hemorrhage]. 1992

T Fujioka, and T Kurihara, and M Kinoshita, and E Satoyoshi, and M Wakayama
Fourth Department of Internal Medicine, Toho University School of Medicine.

A 66-year-old diabetic and hypertensive man suddenly developed right hemiplegia. Examination revealed right hemiplegia including his face, vertical gaze palsy, and divergence paralysis. The cranial CT scan disclosed a left thalamic hemorrhage as large as 40 mm in diameter, which extended to the midbrain. He was treated medically and his divergence paralysis improved. But all other symptoms remained for the next 11 months and he eventually died of acute retroperitoneal hemorrhage. The autopsy revealed spongy state and gliosis extending from the left thalamic nuclei to the left midbrain. In the tegmentum, dorsolateral part around the left oculomotor nucleus was involved. The precise location of the human divergence center of the eyes is still unknown. According to previous reports, the divergence center may locate in the tegmentum of the midbrain or pons. Recently, animal experiments detected the neurons which fire for divergent in the mesencephalic reticular formation just dorsal and lateral to the oculomotor nuclei. Our case had a lesion of gliosis and spongy state, namely the old hematoma, in the same portion. Therefore, we considered that the human divergence center of the eyes might exist in the lateral tegmentum of the midbrain, just lateral and dorsal to the oculomotor nucleus.

UI MeSH Term Description Entries
D008297 Male Males
D009886 Ophthalmoplegia Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles. Oculomotor Paralysis,External Ophthalmoplegia,Internal Ophthalmoplegia,Ophthalmoparesis,External Ophthalmoplegias,Internal Ophthalmoplegias,Ophthalmopareses,Ophthalmoplegia, External,Ophthalmoplegia, Internal,Ophthalmoplegias,Ophthalmoplegias, External,Ophthalmoplegias, Internal,Paralysis, Oculomotor
D002543 Cerebral Hemorrhage Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA. Brain Hemorrhage, Cerebral,Cerebral Parenchymal Hemorrhage,Hemorrhage, Cerebral,Intracerebral Hemorrhage,Hemorrhage, Cerebrum,Brain Hemorrhages, Cerebral,Cerebral Brain Hemorrhage,Cerebral Brain Hemorrhages,Cerebral Hemorrhages,Cerebral Parenchymal Hemorrhages,Cerebrum Hemorrhage,Cerebrum Hemorrhages,Hemorrhage, Cerebral Brain,Hemorrhage, Cerebral Parenchymal,Hemorrhage, Intracerebral,Hemorrhages, Cerebral,Hemorrhages, Cerebral Brain,Hemorrhages, Cerebral Parenchymal,Hemorrhages, Cerebrum,Hemorrhages, Intracerebral,Intracerebral Hemorrhages,Parenchymal Hemorrhage, Cerebral,Parenchymal Hemorrhages, Cerebral
D006429 Hemiplegia Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; and other conditions may manifest as hemiplegia. The term hemiparesis (see PARESIS) refers to mild to moderate weakness involving one side of the body. Monoplegia,Hemiplegia, Crossed,Hemiplegia, Flaccid,Hemiplegia, Infantile,Hemiplegia, Post-Ictal,Hemiplegia, Spastic,Hemiplegia, Transient,Crossed Hemiplegia,Crossed Hemiplegias,Flaccid Hemiplegia,Flaccid Hemiplegias,Hemiplegia, Post Ictal,Hemiplegias,Hemiplegias, Crossed,Hemiplegias, Flaccid,Hemiplegias, Infantile,Hemiplegias, Post-Ictal,Hemiplegias, Spastic,Hemiplegias, Transient,Infantile Hemiplegia,Infantile Hemiplegias,Monoplegias,Post-Ictal Hemiplegia,Post-Ictal Hemiplegias,Spastic Hemiplegia,Spastic Hemiplegias,Transient Hemiplegia,Transient Hemiplegias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013681 Tegmentum Mesencephali Portion of midbrain situated under the dorsal TECTUM MESENCEPHALI. The two ventrolateral cylindrical masses or peduncles are large nerve fiber bundles providing a tract of passage between the FOREBRAIN with the HINDBRAIN. Ventral MIDBRAIN also contains three colorful structures: the GRAY MATTER (PERIAQUEDUCTAL GRAY), the black substance (SUBSTANTIA NIGRA), and the RED NUCLEUS. Accessory Oculomotor Nuclei,Annular Nucleus,Darkshevich's Nucleus,Interstitial Nucleus of Cajal,Mesencephalic Tegmentum,Mesencephalic Trigeminal Nucleus,Midbrain Tegmentum,Midbrain Trigeminal Nucleus,Nucleus Annularis,Nucleus Nervi Trochlearis,Nucleus Sagulum,Nucleus Tractus Mesencephalici Nervi Trigemini,Nucleus of Darkschewitsch,Peripeduncular Nucleus,Sagulum Nucleus,Tegmentum of Midbrain,Trochlear Nucleus,Ventral Tegmental Nucleus,Annulari, Nucleus,Annularis, Nucleus,Cajal Interstitial Nucleus,Darkschewitsch Nucleus,Darkshevich Nucleus,Darkshevichs Nucleus,Mesencephali, Tegmentum,Mesencephalic Tegmentums,Mesencephalus, Tegmentum,Midbrain Tegmentums,Nervi Trochleari, Nucleus,Nervi Trochlearis, Nucleus,Nuclei, Accessory Oculomotor,Nucleus Annulari,Nucleus Nervi Trochleari,Nucleus Sagulums,Nucleus, Annular,Nucleus, Darkshevich's,Nucleus, Mesencephalic Trigeminal,Nucleus, Midbrain Trigeminal,Nucleus, Peripeduncular,Nucleus, Sagulum,Nucleus, Trochlear,Nucleus, Ventral Tegmental,Oculomotor Nuclei, Accessory,Sagulum, Nucleus,Sagulums, Nucleus,Tegmental Nucleus, Ventral,Tegmentum Mesencephalus,Tegmentum, Mesencephalic,Tegmentum, Midbrain,Tegmentums, Mesencephalic,Tegmentums, Midbrain,Trigeminal Nucleus, Mesencephalic,Trigeminal Nucleus, Midbrain,Trochleari, Nucleus Nervi,Trochlearis, Nucleus Nervi
D013786 Thalamic Diseases Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, MOVEMENT DISORDERS; ATAXIA, pain syndromes, visual disorders, a variety of neuropsychological conditions, and COMA. Relatively common etiologies include CEREBROVASCULAR DISORDERS; CRANIOCEREBRAL TRAUMA; BRAIN NEOPLASMS; BRAIN HYPOXIA; INTRACRANIAL HEMORRHAGES; and infectious processes. Dejerine-Roussy Syndrome,Thalamic Syndrome,Dejerine Roussy Syndrome,Disease, Thalamic,Diseases, Thalamic,Syndrome, Dejerine-Roussy,Syndrome, Thalamic,Syndromes, Thalamic,Thalamic Disease,Thalamic Syndromes

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