title: [Bilateral ptosis and upper gaze palsy with pupil sparing caused by midbrain hemorrhage].
abstract: The arrangement within the midbrain oculomotor nerve complex and crossed innervation of the superior rectus muscle are not elucidated in humans. A 65-year-old woman visited our hospital complaining of difficulty opening her eyes. Neurological examination revealed bilateral ptosis and impaired supraduction. The pupils prompty constricted to light. Results of CT and MRI demonstrated that there was a hematoma located in the dorsal midbrain tegmentum that spared the rostral mid-brain. It was presumed that the nerves of the superior rectus and levator palpebrae lie in the midbrain tegmentum more dorsally and medially than the others. Furthermore, crossed innervation of the superior rectus muscle can explain that lesions located in the dorsal midbrain tegmentum cause more often impaired supraduction.
authors.affiliation: Department of Neurosurgery, Hakodate Red Cross Hospital, 6-21 Horikawa-cho, Hakodate-shi, Hokkaido 040-8631, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakatani
authors.forename: Naoki
authors.initials: N
authors.lastname: Ootani
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ishihara
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Uozumi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Miyazawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kato
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Tsuzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nawashiro
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shima
mesh_terms: D000368:Aged; D001763:Blepharoptosis / Q000209:etiology*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008636:Mesencephalon; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D011680:Pupil; D014057:Tomography, X-Ray Computed