case_images: PMC11832234_01
case_images: Diagnostic findings of intracerebral hemorrhage visualized through brain imaging
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case_images: PMC11832234_01_cureus-0017-00000077576-i01.jpg
case_images: FIG1
case_images: He was diagnosed with pontine hemorrhage extending from the midbrain to the medulla oblongata, with perforation of the fourth ventricle, based on head magnetic resonance imaging. He was hospitalized on the same day (Figure 1).
case_images: The measurement environments. (a) The measurement environment of SPEM; the patient was asked to follow the quadrilateral formed by tape on the wall vertically and horizontally with his eyes. (b) The measurement environment of eye movements during walking; the patient was asked to walk 10 m straight at a comfortable speed in the rehabilitation room.. SPEM: smooth pursuit eye movement
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case_images: PMC11832234_01_cureus-0017-00000077576-i02.jpg
case_images: FIG2
case_images: The evaluation parameters were smooth pursuit eye movement (SPEM) and eye movement during walking. The measurement environments are shown in Figure 2. For SPEM (Figure 2a), a quadrilateral was created by placing a piece of tape, 56 cm long and 56 cm wide, on the wall of the rehabilitation room. Eye movements during walking (Figure 2b) were measured with an eye camera while the patient walked with a forearm-supported walker with bilateral axillary support before the start of eye movement training and with a pick-up walker with a watchful eye after two and 10 weeks of eye movement training.
case_images: Scatter plots of pursuit eye movement. (a) Before the start of eye movement training. (b) After 10 weeks of eye movement training. (c) Control. The horizontal axis indicates the angle in the left-right direction of eye movement, whereas the vertical axis indicates the angle in the upward-downward direction of eye movement. A positive value on the horizontal axis indicates eye movement to the right, whereas a negative value indicates eye movement to the left. A positive value on the vertical axis indicates upward eye movement, whereas a negative value indicates downward eye movement.
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case_images: PMC11832234_01_cureus-0017-00000077576-i03.jpg
case_images: FIG3
case_images: Scatter plots of pursuit eye movement are shown in Figure 3. Before the start of eye movement training, the right eye moved -10 to 20 degrees in the horizontal direction and -20 to 80 degrees in the vertical direction; the left eye moved -10 to 20 degrees in the horizontal direction and 0 to 30 degrees in the vertical direction (Figure 3a). After 10 weeks, the right eye moved -20 to 20 degrees laterally and -20 to 20 degrees vertically, and the left eye moved -20 to 20 degrees laterally and -20 to 20 degrees vertically, showing the trajectory of the quadrilateral and crosswise figures on the wall (Figure 3b). Both of the control's eyes moved in the range of -20 to 20 degrees in the horizontal direction and -20 to 20 degrees in the vertical direction (Figure 3c).
case_images: Scatter plots of eye movements during walking. (a) Before the start of eye movement training (walking with a forearm-supported walker). (b) After two weeks of eye movement training (walking with a pick-up walker). (c) After 10 weeks of eye movement training (walking with a pick-up walker). (d) Control (walking with a forearm-supported walker). (e) Control (walking with a pick-up walker). The horizontal axis indicates the angle in the left-right direction of eye movement, whereas the vertical axis indicates the angle in the upward-downward direction of eye movement. A positive value on the horizontal axis indicates eye movement to the right, whereas a negative value indicates eye movement to the left. A positive value on the vertical axis indicates upward eye movement, whereas a negative value indicates downward eye movement.
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case_images: PMC11832234_01_cureus-0017-00000077576-i04.jpg
case_images: FIG4
case_images: Scatter plots of eye movements during walking are shown in Figure 4. Before the start of eye movement training, the study patient's right eye moved between -10 and -5 degrees in the horizontal direction and between five and 10 degrees in the vertical direction, whereas the left eye moved between 25 and 60 degrees in the horizontal direction and between 10 and 25 degrees in the vertical direction (Figure 4a). The gaze of the control moved approximately 0 degrees horizontally and -5 to 0 degrees vertically for the right eye, and 0 to five degrees horizontally and -5 to 0 degrees vertically for the left eye (Figure 4d). The images of both eyes were overlapping (Figure 4b). The images of both eyes overlapped, and the patient no longer complained of diplopia (Figure 4c). The right eye of the control moved within the ranges of 0 degrees in the left-right direction and -5 to five degrees in the vertical direction, whereas the left eye moved within the ranges of -5 to 0 degrees in the left-right direction and -5 to five degrees in the vertical direction (Figure 4e).