Editorial Board

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Editorial Board

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Oral Oncology: August 2017 (Volume 71)

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
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alsfakia@gmail.com

JOURNAL HOME      |         RSS      |      SUBSCRIBE TO JOURNAL     Editorial Board/Aims & Scope      Editorial     Why are we still unable to accurately determine the malignant potential or the behavior of oral mucosal lesions?  Pelin Güneri, Joel B. Epstein      Commentary     Formation of an international intergroup to coordinate clinical trials in head and neck cancers: HNCIG  Quynh Thu Le, John J. Welch, Jan B. Vermorken, Danny Rischin, Hisham Mehanna      Original Articles     A network meta-analysis of the sequencing and types of systemic therapies with definitive radiotherapy in locally advanced squamous cell carcinoma of the head and neck (LASCCHN)☆  Katarzyna J. Jerzak, Keemo Delos Santos, Ronak Saluja, Kelly Lien, Justin Lee, Kelvin K.W. Chan      Long-term survival of a randomized phase III trial of head and neck cancer patients receiving concurrent chemoradiation therapy with or without low-level laser therapy (LLLT) to prevent oral mucositis  Héliton S. Antunes, Daniel Herchenhorn, Isabele A. Small, Carlos M.M. Araújo, Celia Maria Pais Viégas, Gabriela de Assis Ramos, Fernando L. Dias, Carlos G. Ferreira      Prognostic role of tumor infiltrating lymphocytes in EBV positive and EBV negative nasopharyngeal carcinoma  Marc L. Ooft, Jolique A. van Ipenburg, Weibel W. Braunius, Charlotte I. Zuur, Senada Koljenović, Stefan M. Willems      Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer  Anne W. Wendrich, Justin E. Swartz, Sandra I. Bril, Inge Wegner, Alexander de Graeff, Ernst J. Smid, Remco de Bree, Ajit J. Pothen      Survival after refusal of surgical treatment for locally advanced laryngeal cancer  Sean T. Massa, Nosayaba Osazuwa-Peters, Joel Franco, Gregory W. Ward, Ronald J. Walker      Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database  Virginia Osborn, Babak Givi, Anna Lee, Niki Sheth, Dylan Roden, David Schwartz, David Schreiber      External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients  Leandro Luongo Matos, Rogerio Aparecido Dedivitis, Marco Aurélio Vamondes Kulcsar, Evandro Sobroza de Mello, Venâncio Avancini F. Alves, Claudio Roberto Cernea      Impact of combined modality treatment with radiotherapy and S-1 on T2N0 laryngeal cancer: Possible improvement in survival through the prevention of second primary cancer and distant metastasis  Yosuke Kitani, Akira Kubota, Madoka Furukawa, Yukiko Hori, Yuko Nakayama, Tetsuo Nonaka, Nobutaka Mizoguchi, Yuka Kitani, Hiromitsu Hatakeyama, Nobuhiko Oridate      Very accelerated radiotherapy or concurrent chemoradiotherapy for N3 head and neck squamous cell carcinoma: Pooled analysis of two GORTEC randomized trials  Yungan Tao, Anne Aupérin, Pierre Graff, Michel Lapeyre, Vincent Grégoire, Philippe Maingon, Lionel Geoffrois, Pierre Verrelle, Gilles Calais, Bernard Gery, Laurent Martin, Marc Alfonsi, Patrick Deprez, Etienne Bardet, Thierry Pignon, Michel Rives, Christian Sire, Jean Bourhis      Nutritional changes in patients with locally advanced head and neck cancer during treatment  L. Arribas, L. Hurtós, M. Taberna, I. Peiró, E. Vilajosana, A. Lozano, S. Vazquez, R. Mesia, N. Virgili      Transoral thyroidectomy and parathyroidectomy – A North American series of robotic and endoscopic transoral approaches to the central neck  Jonathon O. Russell, James Clark, Salem I. Noureldine, Angkoon Anuwong, Mai G. Al Khadem, Hoon Yub Kim, Vaninder K. Dhillon, Gianlorenzo Dionigi, Ralph P. Tufano, Jeremy D. Richmon      Prognostic value of the eighth edition AJCC TNM classification for differentiated thyroid carcinoma  Tae Hyuk Kim, Young Nam Kim, Hye In Kim, So Young Park, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim, Young Lyun Oh, Soo Yeon Hahn, Jung Hee Shin, Kyunga Kim, Jong Gill Jeong, Sun Wook Kim, Jae Hoon Chung      Dose-dependent enhancement of T-lymphocyte priming and CTL lysis following ionizing radiation in an engineered model of oral cancer  Megan Morisada, Ellen C. Moore, Rachel Hodge, Jay Friedman, Harrison A. Cash, James W. Hodge, James B. Mitchell, Clint T. Allen      A phase I study of cabazitaxel in combination with platinum and 5-fluorouracil (PF) in locally advanced squamous cell carcinoma of head and neck (LA-SCCHN)  Nadia Camille, John Rozehnal, Elizabeth Roy, Dariusz Uczkowski, Ashely Olson, Eric Genden, Marita Teng, Richard Bakst, Vishal Gupta, Marshall Posner, Krzysztof Misiukiewicz      Predictors of readmissions after head and neck cancer surgery: A national perspective  Michelle M. Chen, Ryan K. Orosco, Jeremy P. Harris, Julie B. Porter, Eben L. Rosenthal, Wendy Hara, Vasu Divi      Partner's survivorship care needs: An analysis in head and neck cancer patients  Meredith Giuliani, Robin Milne, Maurene McQuestion, Lorna Sampson, Lisa W. Le, Jennifer Jones, Terry Cheng, John Waldron, Jolie Ringash      Long-term toxicities in 10-year survivors of radiation treatment for head and neck cancer  Yanqun Dong, John A. Ridge, Tianyu Li, Miriam N. Lango, Thomas M. Churilla, Jessica R. Bauman, Thomas J. Galloway      Treatment guidelines and patterns of care in oral cavity squamous cell carcinoma: Primary surgical resection vs. nonsurgical treatment  Rance J.T. Fujiwara, Barbara Burtness, Zain A. Husain, Benjamin L. Judson, Aarti Bhatia, Clarence T. Sasaki, Wendell G. Yarbrough, Saral Mehra      The long-term oncological and functional outcomes of transoral robotic surgery in patients with hypopharyngeal cancer  Young Min Park, Chan Min Jung, Dongchul Cha, Se-Heon Kim      Neighborhood deprivation and risk of head and neck cancer: A multilevel analysis from France  Joséphine Bryere, Gwenn Menvielle, Olivier Dejardin, Ludivine Launay, Florence Molinie, Isabelle Stucker, Daniele Luce, Guy Launoy      Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status  Dan Ou, Pierre Blanchard, Silvia Rosellini, Antonin Levy, France Nguyen, Ralph T.H. Leijenaar, Ingrid Garberis, Philippe Gorphe, François Bidault, Charles Ferté, Charlotte Robert, Odile Casiraghi, Jean-Yves Scoazec, Philippe Lambin, Stephane Temam, Eric Deutsch, Yungan Tao      Early detection of squamous cell carcinoma in carcinogen induced oral cancer rodent model by ratiometric activatable cell penetrating peptides  Dina V. Hingorani, Aaron J. Lemieux, Joseph R. Acevedo, Heather L. Glasgow, Suraj Kedarisetty, Michael A. Whitney, Alfredo A. Molinolo, Roger Y. Tsien, Quyen T. Nguyen      Hardware complications in oromandibular defects: Comparing scapular and fibular based free flap reconstructions  Gordon F.Z. Tsang, Han Zhang, Christopher Yao, Mirko Kolarski, Patrick J. Gullane, Jonathan C. Irish, Dale H. Brown, Douglas B. Chepeha, David P. Goldstein, Ralph W. Gilbert, John R. de Almeida      Special Section - Immunotherapy in Head and Neck Cancer     Neoantigens in immunotherapy and personalized vaccines: Implications for head and neck squamous cell carcinoma  Paul Zolkind, Gavin P. Dunn, Tianxiang Lin, Malachi Griffith, Obi L. Griffith, Ravindra Uppaluri      Letters to the Editor     Why are we still unable to accurately determine the malignant potential or the behavior of oral mucosal lesions?  Gargi S. Sarode, Sachin C. Sarode, Shankargouda Patil      Prediction of distant metastases from nasopharyngeal carcinoma: Improved diagnostic performance of MRI using nodal volume in N1 and N2 stage disease: Methodological issues  Saeid Safiri, Erfan Ayubi      Inflammation in the assessment of salivary cytokines in oral squamous cell carcinoma diagnosis  Özgün Özçaka, Joel B. Epstein, Pelin Güneri      Decoding the signaling pathway initiating cellular migration in cancer metastasis  A. Thirumal Raj      Gamma radiation increases the risk of radiation-related root dental caries  Marilia Mattar de Amoêdo Campos Velo, Ana Laura Herrera Farha, Paulo Sérgio da Silva Santos, Aymée Shiota, Simone Zuquerato Sansavino, Ana Tarsila Fonseca Souza, Heitor Marques Honório, Linda Wang      Formulating a clinicopathological algorithm for oral lichenoid dysplasia and related lesions  A. Thirumal Raj      Need for molecular characterization in immortalized cell lines  Thirumal Raj A.      Names and phenotypes of CD163 positive macrophages in oral precancerous lesions  Xianghe Qiao, Longjiang Li, Chunjie Li      Current issue Volume 71 August 2017     Journal Home   |   Privacy Policy   |   Terms of Use   |   Help & Contact   |   About Us You are currently subscribed as alsfakia@gmail.com. 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The ship as assemblage: Melville’s literary shipboard geographies

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Vertical gaze palsy is usually observed with lesions of the mesencephalic rostral interstitial nucleus, the interstitial nucleus of Cajal, the posterior commissure, and the peri-aqueductal gray matter. Vertical gaze palsies caused by paramedian thalamic infarction without midbrain involvement are rare. A recent stroke study showed that, among 17 Percheron infarct cases, 53% had upgaze restriction, 29% had both upgaze and downgaze restriction, 12% had only downgaze restriction, and 18% had skew de

NEUROIMAGES
Year : 2017  |  Volume : 65  |  Issue : 4  |  Page : 919-920

Vertical gaze palsy due to acute bilateral thalamic infarct without midbrain ischemia

Shakya Bhattacharjee, Kher Lik Ng
Department of Neurology, Plymouth Hospital NHS Trust, Devon, UKCorrespondence Address:

Shakya Bhattacharjee
Flat 96, 21, Plymbridge Lane, Plymouth, PL68AX
UK

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/neuroindia.NI_4_17

How to cite this article: Bhattacharjee S, Ng KL. Vertical gaze palsy due to acute bilateral thalamic infarct without midbrain ischemia. Neurol India 2017;65:919-20

How to cite this URL: Bhattacharjee S, Ng KL. Vertical gaze palsy due to acute bilateral thalamic infarct without midbrain ischemia. Neurol India [serial online] 2017 [cited 2017 Jul 6];65:919-20. Available from: http://ift.tt/2srDQtI

A 62-year old gentleman presented with acute-onset altered sensorium and diplopia on vertical gaze. Clinical examination revealed a pure vertical gaze palsy, which could be overcome by the oculocephalic manoeuvre; however, intact horizontal gaze persisted [video 1]. He had no other pyramidal, extrapyramidal, or cerebellar signs. Magnetic resonance imaging (MRI) of the brain with diffusion sequences showed acute bilateral paramedian thalamic infarcts but with no evidence of midbrain ischemia [Figure 1],[Figure 2],[Figure 3]. He was diagnosed with supranuclear gaze palsy caused by artery of Percheron infarct. The artery of Percheron is a rare solitary arterial trunk from the posterior cerebral circulation that supplies the paramedian thalami and the rostral midbrain bilaterally.

Figure 1: Magnetic resonance imaging (diffusion-weighted sequence) axial view showing high signals in both paramedian nuclei of thalamus (black arrows)

Figure 2: Magnetic resonance imaging (apparent diffusion coefficient) axial view shows low signals in the corresponding thalamic areas suggestive of acute infarction (black arrows)

Vertical gaze palsy is usually observed with lesions of the mesencephalic rostral interstitial nucleus, the interstitial nucleus of Cajal, the posterior commissure, and the peri-aqueductal gray matter.^[1] Vertical gaze palsies caused by paramedian thalamic infarction without midbrain involvement are rare. A recent stroke study showed that, among 17 Percheron infarct cases, 53% had upgaze restriction, 29% had both upgaze and downgaze restriction, 12% had only downgaze restriction, and 18% had skew deviation.^[2] Percheron infarct is a rare variety of thalamic infarct presenting with the classical triad of altered mental status, vertical gaze palsy, and memory impairment.^[2],[3] The exact reason for the vertical gaze palsy in paramedian thalamic infarct is not clear. The most likely reason is the interruption of the supranuclear inputs when they pass through the medial thalamus en route to the pretectal and prerubral areas.^[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 

» References

1.	Khan M, Sidiropoulos C, Mitsias P. Unilateral thalamic infarction presenting as vertical gaze palsy: A case report. J Med Case Rep 2011;5:535.   [PUBMED]
2.	Aaron S, Mani S, Prabhakar AT, Karthik K, Patil AK, Babu PS, et al. Stuck with a drowsy patient, evoke the Percheron. Neurol India 2015;63:542-7.   [PUBMED]  [Full text]
3.	Lazzaro NA, Wright B, Castillo M, Fischbein NJ, Glastonbury CM, Hildenbrand PG, et al. Artery of percheron infarction: Imaging patterns and clinical spectrum. AJNR Am J Neuroradiol 2010;31:1283-9.   [PUBMED]
4.	Clark JM, Albers GW. Vertical gaze palsies from medial thalamic infarctions without midbrain involvement. Stroke 1995;26:1467-70.   [PUBMED]

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