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Year : 2021  |  Volume : 69  |  Issue : 1  |  Page : 232--233

Complete Bilateral Ptosis: An Early Clinical Sign of Herniation in Right Hemispheric Infarction

Suryanarayana Sharma1, JV Mahendra2, A J U A John2, Anish Mehta2, R Srinivasa2,  
1 Senior Consultant Neurologist and Stroke Specialist, Apollo Hospitals, Opposite I.I.M-B, Bannerghatta Road, Bangalore, Karnataka, India
2 Department of Neurology, M.S. Ramaiah Medical College, M.S.R.I.T Post, Bangalore, Karnataka, India

Correspondence Address:
Suryanarayana Sharma
Senior Consultant Neurologist and Stroke Specialist, Apollo Hospitals, Opposite I.I.M-B, Bannerghatta Road, Bangalore, Karnataka
India




How to cite this article:
Sharma S, Mahendra J V, A John A J, Mehta A, Srinivasa R. Complete Bilateral Ptosis: An Early Clinical Sign of Herniation in Right Hemispheric Infarction.Neurol India 2021;69:232-233


How to cite this URL:
Sharma S, Mahendra J V, A John A J, Mehta A, Srinivasa R. Complete Bilateral Ptosis: An Early Clinical Sign of Herniation in Right Hemispheric Infarction. Neurol India [serial online] 2021 [cited 2022 Jul 2 ];69:232-233
Available from: https://www.neurologyindia.com/text.asp?2021/69/1/232/310085


Full Text



 Case Summary



Complete bilateral ptosis (CBP) has been described in massive right Hemispheric lesions.[1] This 49-years-old gentleman presented with left hemiparesis of 4 h duration. CT Brain was done and he was thrombolyzed with r-TPA. Serial neuroimages are shown in [Figure 1]. The patient developed CBP at 24 h, repeat imaging revealed massive right MCA infarction with midline shift, decompression craniotomy was done at 30 h and CBP resolved completely on the second postoperative day [Figure 2]. He had residual hemiplegia and hemineglect at 90 days follow-up. CBP is a valuable clinical sign of massive right hemispheric lesion that precedes herniation providing an opportunity for early intervention.[2]{Figure 1}{Figure 2}

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Blacker DJ, Wijdicks EFM. Delayed complete bilateral ptosis associated with massive infarction of the right hemisphere. Mayo Clin Proc 2003;78:836-9.
2Averbuch-Heller L, Leigh RJ, Mermelstein V, Zagalsky L, Streifler JY. Ptosis in patients with hemispheric strokes. Neurology 2002;58:620-4.