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CT assessment of conjugate eye deviation in acute stroke

From the Calgary Stroke Programme (Drs. Simon, Pexman, Hill, and Buchan), Department of Clinical Neurosciences, University of Calgary, Alberta; and Medical School (S.C. Morgan), Queen’s University, Kingston, Ontario, Canada.

Address correspondence and reprint requests to Prof. A.M. Buchan, Calgary Stroke Programme, Rm. 1162, Foothills Hospital, 1403-29th St NW, Calgary, Alberta, T2N 2T9, Canada; e-mail: abuchan{at}ucalgary.ca

Conjugate eye deviation seen on clinical examination helps to localize pathology in acute ischemic stroke. Eye deviation can also be assessed on a CT head scan. The authors found that CT eye deviation reliably lateralizes to the ischemic hemisphere (positive predictive value 93%) without reference to clinical examination. In an era of thrombolysis and rapid decision making in acute ischemic stroke, eye deviation on CT can help quickly direct attention to the affected hemisphere.

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