Abstract
A 57 year old man consulted us for sudden onset of acuphenes in the right ear, followed by diplopia on forward and downward gaze and paresthesias on the right side of the body. Examination of ocular movements revealed a deficit of the superior oblique muscle of the left eye. CT and MR brainscans imaged a punctate bleed of the left inferior colliculus. The patient was discharged after 16 days still complaining of diplopia on forward and downward gaze. There was no change in neurological status at follow-up. It is rare for an intracerebral hematoma to be located in the midbrain. The case we report is distinguished by the smallness of the lesion and the uncommon neurological deficit it caused.
Sommario
Viene descritto il caso clinico di un uomo di 57 anni giunto alla nostra osservazione per l'improvvisa comparsa di acufeni a carico dell'orecchio destro, seguiti da diplopia nello sguardo in avanti e in basso e perestesie a carico dell'emisoma destro. L'esame della motilità oculare mostrava un deficit del muscolo grande obliquo dell'occhio sinistro. La TAC e la RMN dell'encefalo evidenziavano la presenza di un'emorragia puntiforme a livello del collicolo inferiore sinistro.
Il paziente venne dimesso dopo 16 giorni, mentre ancora lamentava diplopia nello sguardo in avanti e in basso; successivi controlli non evidenziarono variazioni del quadro neurologico.
La localizzazione mesencefalica di un ematoma intracerebrale è un evento raro: il caso da noi descritto si distingue per l'esiguità della lesione emorragica e per il non comune tipo di deficit neurologico da essa causato.
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Cocito, D., Amedeo, G., Gallo, G. et al. Hematoma of the inferior colliculus: uncommon cause of trochlear nerve deficit and contralateral sensory hemisyndrome. Ital J Neuro Sci 11, 71–74 (1990). https://doi.org/10.1007/BF02334909
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DOI: https://doi.org/10.1007/BF02334909