Format

Send to

Choose Destination
Neurocrit Care. 2007;7(3):260-2.

Isolated third nerve palsy associated with a ruptured anterior communicating artery aneurysm.

Author information

1
The Department of Neurological Surgery, The Mayo Clinic, 200 1st Street SW, Rochester, MN 55902, USA. white.brad@mayo.edu

Abstract

INTRODUCTION:

An oculomotor palsy in the setting of aneurysmal subarachnoid hemorrhage is often due to compression by a posterior communicating artery aneurysm. Anterior communicating artery (ACOM) aneurysms may produce ophthalmologic symptoms of the anterior visual pathways, but rarely ever lead to a 3rd nerve palsy. This report describes a rare case of an isolated oculomotor palsy in a patient who experienced subarachnoid hemorrhage from an ACOM aneurysm.

CLINICAL PRESENTATION:

A 46-year-old male presented to the emergency department with headache, emesis, and an isolated left third nerve palsy-the remainder of his exam was normal. A head CT showed diffuse subarachnoid hemorrhage that was later attributed to an ACOM aneurysm as determined by angiography.

INTERVENTION:

Due to the configuration of the aneurysm, it was not deemed treatable by endovascular means. Following a successful clipping, the patient experienced a delayed, transient, monocular visual loss. Upon follow-up, his oculomotor palsy had completely resolved.

CONCLUSION:

In very rare circumstances, an ACOM aneurysm may produce an isolated third nerve palsy. The etiology of the palsy is likely related to clot formation and/or irritating blood products.

PMID:
18008190
DOI:
10.1007/s12028-007-0054-4
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center