眼球运动异常是脑血管病常见的体征,有助于定位和确定可能的病理性质。一般认为,快速水平性眼球运动起于额叶。水平性眼球运动控制通路(额中脑通路)可能是多突触的,通过内囊和基底节附近进入中脑。在中脑和上脑桥结合处交叉,止于对侧脑桥旁中央网状结构(PPRF)。PPRF 与同侧第六神经核团中的运动神经元和中间神经元联系,后者又发出纤维经内侧纵束到对侧动眼神经核团的内直肌核。左额叶产生的快速眼球运动支配经上述通路,由于右侧外直肌和左侧内直肌作用而产生向右的水平快速注视。慢速跟随或跟随(smooth pursuit or following)眼球运动,对运动着的目标做准确的视觉追踪,发自枕顶区。可能以多突触的枕中脑通路下行至同侧的PPRF。右侧枕顶区产生慢速眼球运动支配,以右侧外直肌和左侧内直肌的作用引起向右的水平跟随。除快速和慢速眼球运动外,前庭反射通过 PPRF,使之成为某些其它方式影响眼球运动功能的重要中继站。急性右额叶的破坏性病变引起左侧偏瘫和向左注视麻痹、眼球被另侧正常的左半球“牵拉”向右偏斜(即注视病灶侧)。如起于枕顶区的跟随通路没有被 Eye movement disorders are common signs of cerebrovascular disease, help to locate and determine the possible pathological properties. Generally believed that rapid horizontal eye movement from the frontal lobe. The horizontal eyeball motor control pathway (forehead midbrain pathway) may be poly synaptically, entering the midbrain through the vicinity of the inner capsule and basal ganglia. Crossing at the junction of the midbrain and the superior pons and ending at the contralateral pontine midline reticular network (PPRF). PPRF is associated with motor neurons and interneurons in the ipsilateral sixth nucleus, which in turn emits the medial longitudinal bundle of fibers to the inner rectus constella of the oculomotor nucleus. Rapid eye movements generated by the left frontal lobe dominate the above pathways, resulting in a right-lateral rapid gaze due to the action of the right lateral rectus and left lateral rectus. Slowly follow or follow (smooth pursuit or following) eye movement, moving the target to do an accurate visual tracking, from the pillow area. PPRF may travel down to the ipsilateral side with a multi-synaptic occipital midbrain pathway. The right occipital region produces slow eye movement domination, with the right lateral rectus and left rectus muscle causing the right level to follow. In addition to fast and slow eye movements, vestibular reflexes pass through the PPRF, making it an important relay in some other way that affects eye movement. Destructive lesions of the acute right frontal lobe cause paralysis of the left hemiplegia and left gaze, and the eyeball is “deflected” to the right by the normal left hemisphere of the other side (ie, the lesion side of the gaze). As from the pillow area follow the path is not