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A previously healthy 17-year-old woman developed sudden-onset severe headache with vomiting and acute coma. At an outside emergency department, she underwent a non-contrasted CT scan of head, which showed an extensive spontaneous intraventricular haemorrhage (figure 1A,B). She was intubated for airway protection and admitted to our neurological intensive care unit. A CT cerebral angiogram showed a Spetzler-Martin grade 3 arteriovenous malformation with feeder aneurysm on the pericallosal artery, felt to be the bleeding source. The aneurysm was coiled and a ventriculostomy was placed. As she awakened, she developed abnormal eye movements when attempting upgaze (video 1). Her pupillary light and accommodative responses were intact (not shown in video).
What are these eye findings and to where do they localise?
Contributors MK and EW contributed to drafting and revising the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally reviewed by Mark Lawden, Leicester, UK.