Weber syndrome due to penetrating wound in midbrain

Abstract

Weber syndrome usually presents due to ischaemic or aneurysmal rupture events; to our knowledge, its presentation after a penetrating brain injury has never been reported. Clinical presentation. We report the case of a 52-year male that was assaulted receiving a penetrating trauma in left malar region with brief lost of conciousness. He presented in emergency room with Glasgow coma scale of 9 points, global aphasia, left ptosis, external deviation and midriaticfixed pupil of the left eye, and right hemiplegia. A CT scan was performed on admission, revealing an irregular linear hematoma from the silvian fissure through temporal parenchyma traversing left cerebral peduncle and affecting midbrain left tegmentum. In the next two weeks, the patient recovered muscle power in right arm and leg with subsecuent hospital discharge. Conclusion: penetrating brain injuries affecting the brainstem are rare conditions with high mortality, survival with good prognosis is extremely rare. This is the first case of penetrating brain injury with associated Weber syndrome and survival with partial recovery.