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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous intracerebral hemorrhage rarely occurs in the mesencephalon (midbrain), though thalamic or pontine hemorrhage may extend into that location. The neurologic manifestations and outcome in patients with primary mesencephalic hemorrhage (PMH) are different from those with thalamic or pontine hemorrhage. We report 4 patients (2 men and 2 women) with nontraumatic and non-neoplastic hemorrhages confined to the mesencephalon. One young patient, a 37-year-old woman, had no detectable risk factors for stroke, and her cerebral angiogram was normal. The other 3 elderly patients (73-85 years of age) all had a history of hypertension. The neurologic manifestations of patients with PMH are characterized by disturbance of ocular movements and cerebellar signs. Two patients with tegmental hematoma showed Claude's syndrome, i.e., ipsilateral oculomotor palsy and contralateral cerebellar signs. One patient with a small central midbrain hematoma showed bilateral oculomotor palsy. Another patient with a relatively large central midbrain hematoma presented with bilateral ptosis, bilateral internuclear ophthalmoplegia, upward gaze palsy, and bilateral cerebellar signs. The prognosis after conservative treatment for our patients with PMH was good.
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PMID:[Primary mesencephalic hemorrhage: report of four cases]. 168 95

We describe a unique case of concomitant presentation of three rare mesencephalic syndromes. A 48-year-old man with an acute stoke was found to have an unusual combination of three rare mesencephalic syndromes after detailed neuro-ophthalmic evaluation: the plus-minus lid syndrome, the vertical one-and-a-half syndrome, and Claude's syndrome. We discuss the clinical and anatomical localization of these syndromes. This was corroborated by magnetic resonance imaging (MRI) which revealed areas of infarction at the thalamo-mesencephalic junction and the right rostral midbrain involving the third nerve fascicle and the red nucleus. Our case highlights the importance of a careful ocular motility examination as a tool which has a highly localizing value in the diagnosis of stroke.
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PMID:Concomitant presentation of three rare mesencephalic syndromes: case report. 2043 33

Neurosarcoidosis when encountered by neurologists most commonly presents as cranial neuropathy, peripheral mononeuropathy,polyneuropathy, myopathy, meningitis or myelopathy. There are limited reports in the current literature on the cases of neurosarcoidosis patients presenting with ischaemic stroke. We discuss a 52-year-old patient with a known previous history of cutaneous sarcoidosis presenting with an acute third nerve palsy, facial weakness and ataxia. His magnetic resonance imaging (MRI) brain demonstrated focal signal changes in the midbrain consistent with an acute ischaemic event in the region of his third nucleus, suggesting a partial Claude syndrome presentation. Cerebrospinal fluid (CSF) examination demonstrated an elevated angiotensin-converting enzyme (ACE) level. We discuss the difficulties associated with confirming a diagnosis for his presentation and consider distinctions in stroke in neurosarcoid and its management in comparison to more common causes.
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PMID:Neurosarcoidosis presenting with a partial Claude syndrome. 3174 69