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August 1959, Vol 62, No. 2 >
ARTICLE | August 1959

Supratentorial Mass Lesions Presenting Brain Stem Signs

EDWARD W. D. NORTON, M.D.
AMA Arch Ophthalmol. 1959;62(2):284-286. doi:10.1001/archopht.1959.04220020110016.
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Supratentorial mass lesions presenting classical brain stem signs offer a perplexing problem in diagnosis. Wilson and Winkelman1 have reviewed the occurrence of secondary pontine hemorrhages and have emphasized the misleading significance of the clinical neurological signs; however, little or no attention has been directed to the misleading neuro-ophthalmologic signs found in this condition. It is the purpose of this paper to present two cases with welldefined ocular brain stem signs which led to misdiagnosis of the primary condition.

Report of Cases 

Case 1.—History:  A 75-year-old white woman was admitted to the hospital in a semistuporous condition of about three hours' duration. The past history was significant in that she had undergone a left radical mastectomy seven years previously without evidence of recurrence. Shortly thereafter she had an episode of sudden loss of memory, weakness, and anorexia that cleared in two weeks; she was found to be hypertensive at that

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