A 63-year-old man with hypertension presents after sudden collapse. Vital signs: BP 168/94 mmHg, HR 92/min, RR 16/min, temp 37.2°C. He is intubated and awake. Examination reveals preserved vertical eye movements to command but complete paralysis of all four limbs and lower facial muscles. Sensation to pinprick remains intact throughout. Recent aspirin use noted. MRI shows acute midline pontine infarction. Which vascular lesion best explains this locked-in syndrome presentation?
- A)Right middle cerebral artery infarction
- B)Cervical central cord syndrome
- C)Bilateral medial medullary infarction
- D)Pontine infarction due to basilar artery occlusionGABARITO
- E)Subthalamic nucleus hemorrhage
Explicação
Pontine infarction due to basilar artery occlusion is correct. Locked in syndrome results from ventral pontine damage that interrupts corticospinal and corticobulbar tracts while sparing the reticular activating system and vertical eye movement centers. Patien... Ver explicação completa e trilha adaptativa →