title: Post-traumatic Vertical Gaze Paresis in Nine Patients: Special Vulnerability of the Artery of Percheron in Trauma?
abstract: OBJECTIVE
  The purpose was to present a case series of vertical gaze paresis in patients with a history of cranioencephalic trauma (CET).
  
  
  METHODS
  The clinical characteristics and management are presented of nine patients with a history of CET secondary to motor vehicle accidents with associated vertical gaze paresis.
  
  
  RESULTS
  Neuroimaging studies indicated posttraumatic contusion of the thalamic-mesencephalic region in all nine patients who corresponded to the artery of Percheron region; four patients had signs of hemorrhagic transformation. Vertical gaze paresis was present in all patients, ranging from complete paralysis of the upward and downward gaze to a slight limitation of upward gaze.
  
  
  CONCLUSIONS
  Posttraumatic vertical gaze paresis is a rare phenomenon that can occur in isolation or in association with other neurological deficits and can cause a significant limitation in the quality-of-life. Studies in the literature have postulated that the unique anatomy of the angle of penetration of the thalamoperforating and lenticulostriate arteries makes these vessels more vulnerable to isolated selective damage in certain individuals and can cause-specific patterns of CET.
authors.affiliation: Neuro-ophthalmology Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Alberto
authors.initials: A
authors.lastname: Galvez-Ruiz
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D002536:Cerebral Arteries / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000098:blood supply*; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000209:etiology*; D010291:Paresis / Q000175:diagnosis / Q000209:etiology*; D013788:Thalamus / Q000098:blood supply*; D055815:Young Adult
keywords: Artery of Percheron; Posttraumatic Cerebral Infarction; Vertical Gaze Paresis