Abstract
An 80-year-old woman with a history of hypertension and deep vein thrombosis, who was taking warfarin, presented with sudden-onset coma. Examination was remarkable for wall-eyed bilateral internuclear ophthalmoplegia, small minimally reactive pupils, and spontaneous flexor posturing of the arms. These findings localized to the midbrain and suggested the presence of acute hydrocephalus with compression of the periaqueductal …
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