Author/Authors :
Kılıç, Raşit Ahi Evran University - School of Medicine - Department Of Eye Diseases, Turkey , Kurt, Ali Ahi Evran University - School of Medicine - Department Of Eye Diseases, Turkey , Yavuztürk, Berrin Ahi Evran University - Training and Research Hospital - Department of Emergency, Turkey , Yetiş, Aysu Ahi Evran University - Training and Research Hospital - Department of Neurology, Turkey
Abstract :
A 69-year-old woman was admitted to our emergency clinic with a head trauma and acute onset diplopia following a fall while walking at home. Ophthalmic examination revealed that visual acuity of 20/20 both eyes, pupillary reactions to light and fundus were normal. There was an adduction deficit of right eye and intermittent exotropia of left eye in primary gaze. Ductions were normal in left eye. Left hemiparesis and left positive babinsky were detected by neurological examination. The brain magnetic resonance imaging comfirmed the clinical diagnosis of internuclear ophthalmoplegia as a result of acute ischemic infarction affecting ponto-mesencephalic junction. The adduction deficit, exotropia and the other neurological symptoms resolved in 2 weeks duration. In conclusion, the acute onset of diplopia and exotropia in an old patient with vascular risk factors suggests probability of the acute ponto-mesencephalic junction infarction.
