Síndrome del uno y medio de Fisher a causa de un cavernoma bulbo-protuberancial
- J.A. Andermatten 1
- A. Elua Pinin 1
- N. Samprón Lebed 1
- A. Bollar Zabala 1
- M. Arrazola Schlamilch 1
- E. Urculo Bareño 1
-
1
Hospital Universitario de Donostia
info
ISSN: 0365-6691
Year of publication: 2019
Volume: 94
Issue: 6
Pages: 309-312
Type: Article
More publications in: Archivos de la Sociedad Española de Oftalmologia
Abstract
The one and a half Fisher syndrome is produced by an unilateral lesion in the dorsal and inferior part of the pons located specifically in the pontine tegmentum. This is an area that contains the medial longitudinal fasciculus (LMF), the paramedian pontine reticular formation (PPRF) and the nucleus of the sixth cranial nerve, responsible for the horizontal movements of the gaze. Clinically it manifests with conjugate gaze palsy with internuclear ophthalmoplegia. The case is reported on a 60 year-old patient, who presented with binocular diplopia, ophthalmoplegia and paralysis of the gaze conjugated to the left. Imaging studies were performed that showed a hemi-protuberant haematoma secondary to a cavernoma. As expected, he presented with several episodes of re-bleeding with clinical worsening: headache, diplopia, tetraparesis, and hypoaesthesia in the right side of the face, as such that the microsurgical exeresis of the protuberant cavernoma was considered.