Open Access Case report

Midbrain hematoma presenting with isolated bilateral palsy of the third cranial nerve in a Moroccan man: a case report

Ouarda El Ouali*, Ouafae Messouak and Mohamed F Belahsen

Author Affiliations

Department of Neurology, University Hospital Hassan II, Fez, Morocco

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Journal of Medical Case Reports 2012, 6:197 doi:10.1186/1752-1947-6-197

Published: 16 July 2012

Abstract

Introduction

Bilateral third nerve palsy secondary to a hemorrhagic stroke is exceptional. To the best of our knowledge, no similar case has been reported in the literature.

Case presentation

We describe the case of a 69-year-old Moroccan man who presented with isolated sudden bilateral third nerve palsy. Computed tomography (CT) of the brain revealed a midbrain hematoma. The oculomotor function gradually and completely improved over eight months of follow-up.

Conclusion

Stroke should be included in the differential diagnosis of sudden isolated oculomotor paralysis even when it is bilateral because of the severity of the underlying disease and the importance of its therapeutic implications.