Dorsal midbrain syndrome secondary to a pineocytoma.
BACKGROUND
Dorsal midbrain syndrome is a triad of signs consisting of vertical gaze palsy, light-near dissociation of the pupils, and convergence retraction nystagmus. Associated findings may also be present. The most-common etiologies are pineal gland tumors and midbrain infarction. Pineal gland tumors are rare tumors that show a predilection for males. The specific tumor reported herein, a pineocytoma, shows no gender predilection and is most common in mid- to late adulthood.


METHODS
A 38-year-old Native American man came to us with signs and symptoms consistent with dorsal midbrain syndrome. A neurological evaluation revealed the presence of a pineocytoma, which was later excised unsuccessfully. An explanation of the findings associated with dorsal midbrain syndrome is provided.


CONCLUSIONS
Patients who demonstrate signs consistent with dorsal midbrain syndrome should be referred for a neurological evaluation--including an MRI--to rule out any midbrain lesion.
Allmer
D M
DM
Dakota Vision, Rapid City, South Dakota, USA. allmerd@aol.com
Golis
T A
TA
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D015878:Mydriasis / Q000175:diagnosis / Q000209:etiology; D019635:Neurosurgical Procedures; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000209:etiology*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D010870:Pineal Gland / Q000473:pathology; D010871:Pinealoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013577:Syndrome; D014792:Visual Acuity