riMLF Syndrome from Artery of Percheron Stroke

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Identifier riMLF_syndrome-Gold
Title riMLF Syndrome from Artery of Percheron Stroke
Subject Saccades abnormal; Vestibulo-ocular reflex and head impulse testing normal; Pursuit normal; Vertical gaze palsy; Downgaze palsy; Mesencephalon
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description This is a 65-yo-man who suffered the abrupt onset of loss of consciousness followed by difficulty looking down. MRI showed bilateral rostral midbrain strokes in the distribution of the artery of Percheron. He could not initiate downward saccades and had fair upward saccades. However, downward vestibulo-ocular reflex and smooth pursuit was preserved, thus supporting the supranuclear origin of his downward motility issues. Although the riMLF is responsible for initiation of vertical saccades, projections to the depressor muscles are ipsilateral whereas projections to the elevator muscles are bilateral - therefore, unilateral riMLF damage will cause difficulty with initiation of downward>>upward saccades, while bilateral damage generally abolishes all vertical and torsional saccadic movements. In his case, bilateral riMLF function was not completely abolished given fair upward saccades.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2016
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
File Name riMLF_syndrome-Gold.mp4
Language eng
ARK ark:/87278/s6qg2g63
Setname ehsl_novel_gold
Date Created 2017-02-28
Date Modified 2019-11-21
ID 1209931
Reference URL https://collections.lib.utah.edu/ark:/87278/s6qg2g63
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