PMC10159322_01
Eye movement test on admission. Vertical gaze palsy (upward and downward) was recognized. Each arrow indicates the direction of the eye's gaze in each photo.
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F1
Horizontal eye movements were maintained [Figure 1].
CT on admission. Hemorrhage of 10 x 13 x 13 mm in diameter in the right midbrain tegmental area. The hematoma was predominantly on the right side and partially contralateral.
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F2
A head computed tomography (CT) scan on admission showed a 10 x 13 x 13mm hemorrhage in the tegmentum of the midbrain [Figure 2].
Time course of magnetic resonance imaging ([a and b] on admission [c and d] after 11 days). (a and c) are slice of the level of pineal gland, and (b and c) are slice of the upper level of pineal gland. The hematoma remained in the right cover and the edematous change of the posterior commissure disappeared (arrow).
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F3
A head magnetic resonance (MR) imaging on the same day showed hemorrhage in the midbrain tegmentum and edema in the posterior commissure (PC) [Figures 3a and b]. On the 12th hospital day, all ocular symptoms disappeared except for downward gaze paralysis, and MR imaging during the same period showed that the hematoma was disappearing and the edematous changes near the PC disappeared [Figures 3c and d].