A 70-year-old man with a history of hypertension presented with sudden-onset dizziness, binocular horizontal diplopia, and crooked mouth. His blood pressure was 200/120 mm Hg. Neurologic examination revealed left internuclear ophthalmoplegia (INO) and left-sided peripheral facial palsy (Video 1). His pupillary accommodation reflex and binocular convergence reflection were intact. Head CT and susceptibility-weighted imaging revealed cerebral microbleeds in the pontine tegmentum (Figure, A–C), affecting the left medial longitudinal fasciculus and facial nerve (Figure, D). Pontine tegmentum microbleeds secondary to hypertension were diagnosed. He received nifedipine and atorvastatin. His diplopia and facioplegia improved on the sixth day.

70岁男性，有高血压病史，突发头晕、双眼水平复视、嘴角歪斜。他的血压为 200/120 毫米汞柱。神经系统检查发现左侧核间性眼肌麻痹 (INO) 和左侧周围性面瘫（视频 1）。他的瞳孔调节反射和双眼会聚反射完好无损。头部 CT 和磁敏感加权成像显示脑桥被盖区存在脑微出血（图 A-C），影响左侧内侧纵束和面神经（图 D）。诊断出继发于高血压的桥脑被盖微出血。他接受硝苯地平和阿托伐他汀治疗。第六天，他的复视和面部麻痹症状有所改善。