Ocular Lateral Deviation as a Vestibular Clinical Sign of Medial Posterior Inferior Cerebellar Artery Strokes: A Case Report.

We report a case of posterior circulation stroke that presented with a unique ocular vestibular sign called Ocular Lateral Deviation (OLD). OLD is eye deviation to one side that is made more prominent by brief eye closure. OLD has been reported to occur ipsilesional in a third of medullary strokes, and occasionally in other posterior fossa strokes. Here we report a case of acute stroke that presented with contralesional eye deviation consistent with OLD due to inferior vermis stroke. To our knowledge, this presentation has not been reported before. Clinicians should be aware of potential ocular manifestations of posterior circulation strokes, as these syndromes may not generate significant NIHSS scores and may be missed.