Rare valiant vertical one-and-a-half syndrome without ipsilateral upward gaze palsy in a patient with thalamomesencephalic stroke

Neurol Clin Neurosci. 2018 Sep;6(5):133-135. doi: 10.1111/ncn3.12210. Epub 2018 Jul 11.

Abstract

Bilateral upward and ipsilateral downward gaze palsy due to a unilateral thalamomesencephalic stroke is called vertical one-and-a-half syndrome (VOHS). Here, we report a valiant VOHS case who presented contralateral upward and ipsilateral downward gaze palsy due to a unilateral thalamomesencephalic stroke. The neuronal fiber connections associated with vertical gaze are not completely understood, so the present case provides an important proof to obtain a better understanding of vertical gaze mechanisms.

Keywords: rostral interstitial nucleus of medial longitudinal fasciculus; thalamomesencephalic stroke; vertical one‐and‐a‐half syndrome.