Oculomotor disorders in vertebrobasilar stroke

Abstract:

The stunning and intricate interaction among the different neural circuits for all classes of functional eye movements requires the participation of the entire brain - from the cortex to the brainstem. The frequency of vertebrobasilar stroke has increased over the last two decades and emergency department physicians and specialists caring for stroke patients should, therefore, have the appropriate clinical skills for the timely recognition of posterior circulation strokes. Moreover, organization of the brainstem relative to vascular supply is key to a number of well-known syndromes whose clinical hallmarks may be oculomotor disorders. Diagnosis of brainstem stroke can often be challenging, particularly in the acute stage when CT scans and conventional MRI are normal or show only subtle changes. Consequently, stroke diagnosis continues to be based on clinical findings, where careful bedside clinical examination of eye movements can usually reveal a broad gamut of oculomotor abnormalities that are helpful in accurately determining the lesion site and, in some cases, may suggest the underlying etiology. This article summarizes the neural substrate of eye movements, the brainstem vascular supply and the different patterns of eye movement disorders due to stroke in the posterior circulation. © 2009 Expert Reviews Ltd.

Año de publicación:

2009

Keywords:

• Brainstem
• Gaze palsy
• Nystagmus
• Oculomotor disorder
• Cerebral infarct
• Eye movement disorder

Fuente:

scopus