{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:15:10Z","timestamp":1740147310228,"version":"3.37.3"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cardiac catheterization and endovascular procedures are extensively used in modern medicine, and procedural stroke is one of the major complications that the catheterization laboratory team may face in their everyday work. Recognizing the signs and symptoms of procedural stroke is crucial to ensuring appropriate management. We herein report a case of internuclear ophthalmoplegia that caused blurred vision, diplopia, and dizziness on lateral gaze as an unusual presentation of procedural stroke.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 60-year-old Thai woman underwent right partial colectomy and was diagnosed with stage IV diffuse large B-cell lymphoma. Pre-chemotherapy echocardiography revealed mild left ventricular systolic dysfunction, and she therefore underwent diagnostic catheterization. Coronary angiography revealed normal coronary arteries, leading to a diagnosis of non-ischemic cardiomyopathy. After the procedure, she immediately developed dizziness and diplopia. During the right lateral gaze, she exhibited impaired adduction of the left eye and horizontal nystagmus of the right eye. A diagnosis of left internuclear ophthalmoplegia was made. Magnetic resonance imaging revealed a tiny area exhibiting characteristics of an acute infarct in the left paramedian midbrain, including the left medial longitudinal fasciculus, which explained the clinical picture. Another region of restricted diffusion indicating an acute infarct was detected in the right inferior cerebellar hemisphere. Magnetic resonance angiography revealed no significant cerebral artery disease. The patient achieved full neurological recovery 6\u00a0weeks after symptom onset.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This report describes an uncommon presentation of procedural stroke that is likely to be misdiagnosed, especially by medical staff unfamiliar with internuclear ophthalmoplegia. Despite the good prognosis of internuclear ophthalmoplegia, appropriate stroke care is crucial in patients with procedural stroke because of the risk of multiple brain infarcts.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04401-w","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T01:02:26Z","timestamp":1707267746000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Internuclear ophthalmoplegia as a presentation of procedural stroke: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9882-0953","authenticated-orcid":false,"given":"Norachai","family":"Sirisreetreerux","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6416-881X","authenticated-orcid":false,"given":"Krongkamol","family":"Ponglikitmongkol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,7]]},"reference":[{"key":"4401_CR1","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.1161\/CIR.0000000000000757","volume":"141","author":"SS Virani","year":"2020","unstructured":"Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee, et\u00a0al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141:e139\u2013596.","journal-title":"Circulation"},{"issue":"1","key":"4401_CR2","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1161\/01.CIR.0000020678.16325.E0","volume":"106","author":"S Fuchs","year":"2002","unstructured":"Fuchs S, Stabile E, Kinnaird T, Mintz GS, Gruberg L, Ca\u00f1os D, et\u00a0al. Stroke complicating percutaneous coronary interventions. Circulation. 2002;106(1):86\u201391.","journal-title":"Circulation"},{"key":"4401_CR3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.2217\/ica.11.37","volume":"3","author":"N Werner","year":"2011","unstructured":"Werner N, Zeymer U. Stroke outcomes in patients undergoing percutaneous coronary intervention in clinical practice today. 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Consent for treatment is not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}