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Bilateral upward and ipsilateral downward gaze palsy due to a unilateral thalamomesencephalic stroke is called vertical one‐and‐a‐half syndrome ( VOHS ). Here, we report a valiant  VOHS  case who presented contralateral upward and ipsilateral downward gaze palsy due to a unilateral thalamomesencephalic stroke. The neuronal fiber connections associated with vertical gaze are not completely understood, so the present case provides an important proof to obtain a better understanding of vertical gaze mechanisms.

Rare valiant vertical one‐and‐a‐half syndrome without ipsilateral upward gaze palsy in a patient with thalamomesencephalic stroke