supranuclear gaze palsy after cardiac surgery

Q: A supranuclear gaze palsy is more common after? (select one) 

 A) mitral valve replacement 
B) aortic valve replacement


Answer: B

A Supranuclear gaze palsy is under-recognized but a well known complication after cardiac surgeries, specially aortic valve replacement and repair of an ascending aortic dissection. It is usually accompanied by spastic dysarthria and gait disorder. This is probably due to ischemic injury to the midbrain, or brainstem.

#surgical-critical-care
#neurology


References: 

1.  Solomon D, Ramat S, Tomsak RL, et al. Saccadic palsy after cardiac surgery: characteristics and pathogenesis. Ann Neurol 2008; 63:355.

2.  Devere TR, Lee AG, Hamill MB, et al. Acquired supranuclear ocular motor paresis following cardiovascular surgery. J Neuroophthalmol 1997; 17:189.

3. Mokri B, Ahlskog JE, Fulgham JR, Matsumoto JY. Syndrome resembling PSP after surgical repair of ascending aorta dissection or aneurysm. Neurology 2004; 62:971.