Contralateral gaze deviation with supratentorial hemorrhage.
Three patients with spontaneous supratentorial intracerebral hemorrhage had contralateral sustained conjugate gaze deviation. The autopsies disclosed large thalamic-basal ganglia hemorrhages whose caudal extension was limited to the midbrain. Current knowledge of oculomotor localization does not adequately explain this "wrong-side" gaze deviation, and the mechanism remains obscure. The present cases suggest that thalamic hemorrhage can produce contralateral gaze deviation without involving postdecussation horizontal oculomotor pathways. Contralateral gaze deviation is not a rare occurrence with deep supratentorial hemorrhages, and awareness of this confusing sign should assist in localizing intracerebral hematomas.
D000368:Aged; D001479:Basal Ganglia; D001921:Brain / Q000473:pathology; D001933:Brain Stem; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013285:Strabismus / Q000209:etiology*; D013788:Thalamus