Oculomotor nerve palsy associated with internal carotid artery: case reports
- Author:
Hyung Il KIM
1
;
Han Joo CHOI
Author Information
1. Department of Emergency Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. iqtus@hanmail.net
- Publication Type:Case Report
- Keywords:
Oculomotor nerve diseases;
Aneurysm;
Internal carotid artery
- MeSH:
Aged;
Aged, 80 and over;
Aneurysm;
Angiography;
Anisocoria;
Brain;
Carotid Artery, Internal;
Cerebral Angiography;
Diagnosis;
Diffusion;
Diplopia;
Emergency Service, Hospital;
Female;
Humans;
Hypertension;
Ischemia;
Magnetic Resonance Angiography;
Magnetic Resonance Imaging;
Mortality;
Mydriasis;
Oculomotor Nerve Diseases;
Oculomotor Nerve;
Physical Examination
- From:Journal of the Korean Society of Emergency Medicine
2019;30(2):198-204
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Oculomotor nerve palsy limits the specific direction eyeball movement, and represents diplopia, mydriasis, and ptosis. The vascular-associated etiologies of oculomotor nerve palsy are the microvascular ischemia due to hypertension or diabetes, or compression of the nerve by the aneurysm. For the aneurysm, if not treated properly, it may result in mortality or severe neurological impairment. Thorough history taking, physical examinations, and proper imaging modality are needed to make an accurate diagnosis. A 76-year-old female with decreased mentality and anisocoria presented at our emergency department. An 83-year-old female presented with right ptosis and lateral-side deviated of the right eyeball. No definite lesion was noted on the initial non-contrast brain computed tomography (CT) and magnetic resonance imaging diffusion. An aneurysm was detected on CT angiography taken several hours later in the former patient. For the latter patient, a giant aneurysm was detected on magnetic resonance angiography that had been performed at another hospital 4 days earlier. These two patients underwent transfemoral cerebral angiography with coiling. They were discharged with no neurological sequelae.
