本文報告一例因頭部外傷,導致垂直性複視的病例,病人的眼部異常,僅侷限於單眼上轉麻痺及短暫的瞳孔不等大,核磁共振造影檢查發現於中腦右側動眼神經核複合體出現一出血病灶,該病灶為造成左眼眼球上轉麻痺之成因。 中腦出血導致對側單一條上直肌麻痺是十分罕見的,本病例正可證實Warwick於1953年所創立的觀念,亦即上直肌的動眼神經亞神經核支配對側的上直肌。
We report a patient with vertical diplopia after head injury, who had dysfunction restricted to monocular elevation paresis and transient anisocoria. T2 MRI study demonstrated a lesion involving the oculomotor nuclear complex consistent with a hemorragic lesion in the midbrain. Isolated midbrain hemorrages with single extraocular muscle involvement is very uncommon. The result of this case verifies Warwick's concept of crossed innervation of the superior rectus muscle in human.