Concluded Case

One and a half syndrome 2ndary to Pontine infarction.

71 yr ,M, with acute onset of vertigo with left sided weakness developed when he woke up at 5 AM on 24th March with back ground history of DM and hypertension Chief Complaints Presented with acute onset of subjective vertigo ,vomited once and developed left sided weakness on 24th early morning. Denied having any headache or alteration in sensorium. Vertigo lasted for 2 hrs. On the way to hospital he noted difficulty to hold things and he told his wife that his right hand was not under his control. Denied having diplopia. No sensory abnormality noted. History Known hypertensive 20 yrs and Diabetic for15 yrs.On med for hypothyroidism.Non smoker.,not in the habit of taking ethanol. Vitals Afebrile,Bp160/ 80 mmhg. Hr 66/ mt. Physical Examination Concious,mildly dysarthric. No horner's syndrom.Normal pupils. On asking to look to the left side, nystagmus was noted on the left eye in the left lateral position and the rt eye wasn't adducting. On asking to look to rt side rt eye abduction was normal and left eye adduction was full.Mild facial asymmetry lt side .left sided power gr 4/ 5 with normal power on the rt side. DTRS MILDLY hyeractive left side with rt sided cerebellar signs.Dulling of sensation rt side of face also noted Investigations FBS 140 mg / dl.HbA1c 7.2%. TSH 2.3.ECG - normal. MRI done,report for duscussion. Diagnosis Diagnosis is clear in the MRI. Stroke. Management Patient is on medical management as per stroke protocol Duscusdion. What abnormality in the MRI brain. What is the diagnosis ? What abnormality in the ocular movement and what is the name of the ocular abnormality?

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Thanks for all answeres. Abnormality in the eye movements- One and a half syndrome NRI brain - T2 / FLAIR hyperintense lesion in the antero lateral badilar pons

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Thanks for all answeres. Abnormality in the eye movements- One and a half syndrome NRI brain - T2 / FLAIR hyperintense lesion in the antero lateral badilar pons

Stroke In ayurved Rx Abhyadi qwath + hingu trigun oil 1 teaspoon bd Galo ghan tab 1bd for 2 to 3 weeks,

Possibly brain stem involvement of stroke.

RT cavernous sinus thrombosis