Isolated unilateral ptosis as a presenting feature of midbrain infarction

Description A 60-year-old female patient, non-smoker, with known case of coronary artery disease (CAD) but treatment defaulter, presented to us with complaints of sudden-onset vertigo followed by drooping of the left eyelid without any diurnal fluctuation for the last 3 days. In literature, cases of...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2018-02, Vol.2018, p.bcr-2017-223750
Main Authors: Kumawat, Banshi Lal, Panchal, Maulik, Sagar, Deepika
Format: Article
Language:English
Subjects:
Aneurysms
Blepharoptosis - etiology
Brain Stem Infarctions - complications
Cardiovascular disease
Case reports
Female
Humans
Images In
Magnetic Resonance Imaging
Medical imaging
Mesencephalon - blood supply
Mesencephalon - diagnostic imaging
Middle Aged
Stroke
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Description A 60-year-old female patient, non-smoker, with known case of coronary artery disease (CAD) but treatment defaulter, presented to us with complaints of sudden-onset vertigo followed by drooping of the left eyelid without any diurnal fluctuation for the last 3 days. In literature, cases of unilateral or bilateral ptosis with or without extraocular muscles involvement in case of midbrain infarction have been described rarely which is explained by selective oculomotor nerve fascicles lesions. 1 2 Figure 1; (A) MRI of the brain with diffusion-weighted image shows diffusion restriction in the left paramedian midbrain region with corresponding fall in apparent diffusion coefficient (B). Learning points Although acute or sudden-onset, isolated unilateral ptosis has many differentials, painless ptosis in an elderly patient with vascular risk factors should make us think about the possibility of midbrain infarct, and MRI brain with diffusion-weighted image should be done urgently.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-223750