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A Case of Parinaud Syndrome After Intracranial Hemorrhage

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À̼ҿ¬ ( Lee So-Yeon ) - ÀÎÇÏ´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç

À±»ó¿ø ( Yoon Sang-Won ) - ÀÎÇÏ´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
°­¼º¸ð ( Kang Sung-Mo ) - ÀÎÇÏ´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç

Abstract

¸ñÀû: ³úÃâÇ÷ ÈÄ ¹ß»ýÇÑ ÆÄ¸®³ëµåÁõÈıº 1¿¹¸¦ °æÇèÇÏ¿© º¸°íÇϰíÀÚ ÇÑ´Ù.

Áõ·Ê¿ä¾à: 45¼¼ ³²ÀÚ È¯ÀÚ°¡ ¿ìÃø ¿îµ¿ ¾àÈ­(weakness) ¹× ¿ìÃø °¨°¢ ÀúÇÏ ¼Ò°ßÀ» ÁÖ¼Ò·Î ³»¿øÇÏ¿´´Ù. ³ú Àü»ê ´ÜÃþ ÃÔ¿µ »ó ÁÂÃø ½Ã»ó ¹× ³»½Ç¿¡ ÃâÇ÷ ¼Ò°ßÀÌ º¸¿© °íÇ÷¾Ð¼º ³úÃâÇ÷·Î ½Å°æ¿Ü°ú¿¡ ÀÔ¿øÇÏ¿´´Ù. ÀçȰ ÀÇÇаú¿¡¼­ Ä¡·á¸¦ ¹Þ´ø Áß ¼öÁ÷ Áֽà ¸¶ºñ ¹× º¹½Ã¸¦ È£¼ÒÇÏ¿© ½ÃÇàÇÑ ¾È±¸ ¿îµ¿ °Ë»ç»ó Á¦ÀÏ ´«À§Ä¡¸¦ Æ÷ÇÔÇÑ ¸ðµç ¹æÇâ¿¡¼­ º¹½Ã ¼Ò°ßÀÌ ÀÖ¾úÀ¸¸ç »ó¹æ 15µµÀÇ ¼öÁ÷ Áֽà Á¦ÇÑÀÌ ÀÖ¾ú´Ù. ´«²¨Ç® ÈÄÅð, ´«¸ðÀ½½Ã ¾È±¸ ÈÄÅð, ¾È±¸ ÁøÅÁÀ» º¸¿´À¸¸ç ºû-Á¢±Ù¹Ý»ç ÇØ¸® ¼Ò°ßÀÌ °üÂûµÇ¾ú´Ù. ȯÀÚ´Â ³úÃâÇ÷ ¹ß»ý ÈÄ 2³âÀÌ Áö³­ ½ÃÁ¡¿¡¼­ ±³Á¤ ½Ã·Â ¾ç¾È 1.0À̳ª ´«¸ðÀ½ ÈÄÅð¾ÈÁø ¹× ºû-Á¢±Ù¹Ý»ç ÇØ¸®, »ó¹æ Áֽà ¸¶ºñ Áõ»óÀº È£ÀüµÇÁö ¾Ê¾ÒÀ¸¸ç ÃßÀû°üÂû ÁßÀÌ´Ù.

°á·Ð: ÆÄ¸®³ëµåÁõÈıºÀº ÀÏ´Ü Áõ»óÀÌ ¹ßÇöµÈ ÈÄ¿¡´Â ¼öµÎÁõÀ» Á¦¿ÜÇÑ ´ëºÎºÐÀÇ °æ¿ì Áõ»óÀÇ È£ÀüÀ» ±â´ëÇÏ±â ¾î·Æ´Ù. ƯÈ÷ Áõ»óÀÌ ¹ßÇöµÈ ÈĺÎÅÍ 6°³¿ù ÀÌ»ó Áõ»óÀÇ È£ÀüÀÌ ¾ø¾ú´Ù¸é Áõ»óÀÌ ¿ÏÀüÈ÷ È£ÀüµÉ °¡´É¼ºÀº ¸Å¿ì Èñ¹ÚÇÏ´Ù. ½Ã»ó ¹× ³»½Ç ÃâÇ÷ ÈÄ ¹ß»ýÇÑ ÀüÇü ÀûÀΠ¡Èĸ¦ µ¿¹ÝÇÑ ÆÄ¸®³ëµåÁõÈıºÀ» °æÇèÇÏ¿´±â¿¡ º¸°íÇÏ´Â ¹ÙÀÌ´Ù.

Purpose: To report one case of Parinaud syndrome after intracranial hemorrhage.

Case summary: A 45-year-old man visited our emergency department complaining of right-sided weakness and right-sided hypoesthesia. Intracranial hemorrhage in the left thalamus and intraventricular hemorrhage were noted upon brain computed tomography, and the patient was admitted to the department of neurosurgery. He complained of diplopia and upgaze palsy, and he was referred to the department of ophthalmology. The patient exhibited convergence-retraction nystagmus, light-near dissociation and vertical gaze limitation within 15 degrees. The best-corrected visual acuity of both eyes was 20/20, but convergence-retraction nystagmus and light-near dissociation still remained. Upgaze palsy was also not improved.

Conclusions: Once symptoms manifest, Parinaud syndrome does not resolve except in patients with hydrocephalus. If the findings persist for more than 6 months, the likelihood of complete resolution is very small. We reported a case of typical Parinaud syndrome with upgaze palsy, convergence-retraction nystagmus and light-near dissociation after thalamic and intraventricular hemorrhage.

Ű¿öµå

Convergence-retraction nystagmus;Light-near dissociation;Upgaze palsy
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