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Painless, Pupil-Sparing but Otherwise Complete Oculomotor Nerve Paresis Caused by Basilar Artery Aneurysm

Painless, Pupil-Sparing but Otherwise Complete Oculomotor Nerve Paresis Caused by Basilar Artery... Abstract To the Editor. —Oculomotor nerve paresis is a well-known sign of enlargement or rupture of an intracranial aneurysm. The aneurysm is usually located at the junction of the posterior communicating and internal carotid arteries, but occasionally may be at the tip of the basilar artery. The oculomotor nerve paresis may be complete or incomplete, but it is usually characterized by damage to pupillomotor fibers, resulting in an enlarged, poorly reactive pupil on the side of the paresis. In addition, oculomotor nerve paresis caused by an intracranial aneurysm is almost always associated with severe ocular or periorbital pain. We describe a patient in whom an intracranial aneurysm that originated at the tip of the basilar artery produced a painless, pupil-sparing, but otherwise complete oculomotor nerve paresis. Report of a Case. —A 65-year-old, hypertensive woman presented to the Wilmer Institute of The Johns Hopkins Hospital, Baltimore, with a one-month history of complete References 1. Miller NR: Walsh and Hoyt's Clinical Neuro-Ophthalmology , ed 4. Baltimore, Williams & Wilkins, 1985, vol 2, pp 668-670. 2. Kissel JT, Burde RM, Klingele TG, et al: Pupil-sparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms . Ann Neurol 1983;13:149-154.Crossref 3. Trobe JD: Isolated pupil-sparing third nerve palsy . Ophthalmology 1985;92:58-61.Crossref 4. Bixenman WW: Atypical clinical presentation of oculomotor (III) nerve palsy . J Clin Neuro Ophthalmol 1982;2:249-258. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Painless, Pupil-Sparing but Otherwise Complete Oculomotor Nerve Paresis Caused by Basilar Artery Aneurysm

Archives of Ophthalmology , Volume 106 (5) – May 1, 1988

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1988.01060130633009
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —Oculomotor nerve paresis is a well-known sign of enlargement or rupture of an intracranial aneurysm. The aneurysm is usually located at the junction of the posterior communicating and internal carotid arteries, but occasionally may be at the tip of the basilar artery. The oculomotor nerve paresis may be complete or incomplete, but it is usually characterized by damage to pupillomotor fibers, resulting in an enlarged, poorly reactive pupil on the side of the paresis. In addition, oculomotor nerve paresis caused by an intracranial aneurysm is almost always associated with severe ocular or periorbital pain. We describe a patient in whom an intracranial aneurysm that originated at the tip of the basilar artery produced a painless, pupil-sparing, but otherwise complete oculomotor nerve paresis. Report of a Case. —A 65-year-old, hypertensive woman presented to the Wilmer Institute of The Johns Hopkins Hospital, Baltimore, with a one-month history of complete References 1. Miller NR: Walsh and Hoyt's Clinical Neuro-Ophthalmology , ed 4. Baltimore, Williams & Wilkins, 1985, vol 2, pp 668-670. 2. Kissel JT, Burde RM, Klingele TG, et al: Pupil-sparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms . Ann Neurol 1983;13:149-154.Crossref 3. Trobe JD: Isolated pupil-sparing third nerve palsy . Ophthalmology 1985;92:58-61.Crossref 4. Bixenman WW: Atypical clinical presentation of oculomotor (III) nerve palsy . J Clin Neuro Ophthalmol 1982;2:249-258.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1988

References