Introduction: The oculomotor disorders due to mesencephalic pathology are very varied. Function of the third cranial nerve may be affected at the level of the nucleus, in the mesencephalic fascicular portion, interpeduncular fossa, pathway anterior to the posterior communicating artery, sinus cavernosus, sphenoid fissure and orbit. Paralysis of the common oculomotor nerve is the least common of these. Generally it is secondary to ischemic, or sometimes to hemorrhagic vascular pathology.
Clinical case: We present the case of a hypertensive woman with an oculomotor nerve syndrome associated with limitation of horizontal gaze of the contralateral eye and reactive head inclination due to a mesencephalic haematoma.
Conclusion: The three neuro-ophthalmological findings seen in our patient have rarely been described in the literature. We consider the clinical observation of this case and the study of the organization of the oculomotor nerve nucleus to be of interest for publication.