| Identifier |
Ocular_Dipping_Gold |
| Title |
Ocular Dipping and Ping-pong Gaze Due to Bi-hemispheric Strokes |
| Creator |
Julie Christine Gudenkauf, MD; Arens Taga, MD; Jiaying Zhang, MD; Daniel Gold, DO |
| Affiliation |
(JCG) Department of Neurology, Johns Hopkins, Baltimore, Maryland; (AT) Department of Neurology, Johns Hopkins, Baltimore, Maryland; (JZ) Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, Maryland; (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland |
| Subject |
Pons; Ocular Dipping |
| Description |
This is a 51-year-old man presenting with hypertensive left thalamic intracerebral hemorrhage and intraventricular hemorrhage, with course complicated by multifocal supratentorial ischemic strokes. He developed abnormal movements characterized by slow, conjugate, horizontal deviations, consistent with ping-pong gaze. This likely represents a release phenomenon due to disconnection between the cerebral cortex and pontine horizontal gaze centers. Additionally, there were intermittent slow, conjugate downward movements with a fast return to primary position, consistent with ocular dipping. Likewise, this might be due to a disconnection between cerebral cortex/basal ganglia and midbrain vertical gaze centers. Our case extends the spectrum of potential causes of ocular dipping to include multifocal supratentorial lesions, in addition to the previously described more diffuse and symmetric bi-hemispheric processes, such as anoxic brain injury and Creutzfeldt-Jakob disease [1,2]. |
| Date |
2022 |
| References |
[1] Ropper AH. Ocular dipping in anoxic coma. Arch Neurol. 198; 38(5):297-9. [2] Schneider J, Rossetti AO, Alvarez V. Ocular bobbing/dipping after cardiac arrest may be a post-anoxic myoclonus. Resuscitation. 2018; 124:e7. |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Dan Gold Neuro-Ophthalmology Collection: https://novel.utah.edu/Gold/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890 |
| Rights Management |
Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6qznj24 |
| File Name |
Ocular_dipping_and_ping_pong_gaze_due_to_bi_hemispheric_strokes.mp4 |
| Setname |
ehsl_novel_gold |
| ID |
2033224 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6qznj24 |
