title: Midbrain hemorrhage presenting as bilateral ptosis without hemiplegia: a case report.
abstract: A 66-year-old man suddenly developed bilateral ptosis after awaking from a nap. He did not experience nausea, vomiting or headache. In the emergency room, high blood pressure was noted. On examination, his consciousness was clear. Ptosis was present bilaterally and worse on the right side. The pupils promptly constricted to light. He could fully adduct his eyes during conjugate gaze movements, but convergence was impaired in the right eye. There was no diplopia or nystagmus. The assessment of the motor and sensory systems revealed no significant findings. Computed tomographic scanning and magnetic resonance imaging of the brain showed a small hematoma in the midbrain. Six months later, ptosis improved; however, the convergence deficit remained.
authors.affiliation: Section of Neurology, Neurological Institute, Veterans General Hospital-Taipei, Taiwan, R.O.C.
authors.forename: D B
authors.initials: DB
authors.lastname: Chang
authors.forename: Y Y
authors.initials: YY
authors.lastname: Lin
authors.forename: W Y
authors.initials: WY
authors.lastname: Guo
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: C P
authors.initials: CP
authors.lastname: Tsai
authors.forename: K P
authors.initials: KP
authors.lastname: Lin
authors.forename: K K
authors.initials: KK
authors.lastname: Liao
mesh_terms: D001763:Blepharoptosis / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis; D006406:Hematoma / Q000150:complications / Q000175:diagnosis; D006429:Hemiplegia; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon; D008875:Middle Aged; D009802:Oculomotor Nerve; D014057:Tomography, X-Ray Computed