Bilateral Third Nerve Palsy in Mirror Aneurysms of the Posterior Communicating Arteries

Gomez-Figueroa, Enrique and Cardenas-Saenz, Omar and Quiñones-Pesqueira, Gerardo and Cervantes-Uribe, Roberto and Calleja-Castillo, Juan Manuel (2018) Bilateral Third Nerve Palsy in Mirror Aneurysms of the Posterior Communicating Arteries. European Journal of Case Reports in Internal Medicine, 5 (8). ISSN 2284-2594

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Background: Bilateral third cranial nerve palsy has only been reported in a handful of conditions including some with inflammatory, tumoural and vascular causes. An urgent imaging study is mandatory to rule out vascular aetiology, mainly aneurysmal subarachnoid haemorrhage (aSAH). Case presentation: A 28-year-old Hispanic woman presented to the emergency department with a 21-day history of a sudden-onset and severe headache that on three occasions was accompanied by transient loss of awareness, the last episode occurring a week previously. The simple CT image showed minimal bleeding at the level of the perimesencephalic cisterns, with evidence of SAH. An angioCT revealed a 5×6 mm bilobed saccular aneurysm of the right posterior communicating artery and a 2×2 mm saccular aneurysm in the posterior left communicating artery. Conclusions: A mirror aneurysm is found in 2–25% of aSAH cases. To date there is no consensus about the optimal management of patients with these findings.

Item Type: Article
Uncontrolled Keywords: Third nerve palsy, oculomotor nerve palsy, subarachnoid hemorrhage, mirror aneurysm, thunderclap headache
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Greta Di Blasio
Date Deposited: 11 Jun 2019 15:38
Last Modified: 11 Jun 2019 15:38

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