Parinaud’s syndrome due to an unilateral vascular ischemic lesion


A 59-year-old man who complained of binocular vertical diplopia after an exploratory laparotomy, complicated by cardiorespiratory arrest during anesthetic induction, was found to have Collier’s sign, anisocoria, complete paralysis of upward vertical gaze associated with convergence-retraction nystagmus on attempted upgaze and skew deviation with hypertropia in the left eye without ptosis, and an absent Bielschowsky sign. Magnetic resonance imaging of the brain showed a small lesion in the left paramedian midbrain compatible with microvascular ischemic sequelae. This patient was diagnosed with Parinaud’s syndrome (dorsal midbrain syndrome) associated with a vertical strabismus from an unilateral vascular ischemic paramedian midbrain lesion.

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The authors declare that they have no conflict of interest.

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The manuscript does not contain clinical studies with human participants or animals performed by any of the authors. Informed consent was obtained from individual participant included in the study. Additional informed consent was obtained from the individual participant for whom identifying information is included in this article.

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Correspondence to Josefina Serino.

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Converge-retraction nystagmus on attempting an upward gaze (MPG 2190 kb)

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Converge-retraction nystagmus on attempting an upward gaze (MPG 2190 kb)

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Serino, J., Martins, J., Páris, L. et al. Parinaud’s syndrome due to an unilateral vascular ischemic lesion. Int Ophthalmol 35, 275–279 (2015) doi:10.1007/s10792-015-0045-y

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  • Parinaud’s syndrome
  • Dorsal midbrain syndrome
  • Convergence-retraction nystagmus
  • Skew deviation
  • Interstitial nucleus of Cajal