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Pupil-Sparing Oculomotor Palsy Caused by Fusiform Ateriosclerotic Aneurysm of the Basilar Artery—A Case ReportVA Medical Center, Buffalo, New York
VA Medical Center, Buffalo, New York
VA Medical Center, Buffalo, New York Paresis of the oculomotor nerve is a very rare complication of an unrup tured arteriosclerotic fusiform aneu rysm of the basilar artery. A handful of cases are described in the world literature. A fifty-four-year-old man with a history of hypertension and diabetes mellitus presented with painless par tial oculomotor palsy of sudden onset. A cerebral angiogram demonstrated a tortuous fusiform deformity of the basilar artery and the origin of the posterior cerebral arteries, indica tive of all arteriosclerotic aneurysmal dilation. A sudden onset of a pupil-sparing ophthalmoplegia is the typical history of a microvascular infarct of the third nerve, whereas pupillary sparing in aneurysmal oculomotor paresis is a very rare event. Special emphasis has been placed on the pupillary size as a guide for the indication of arteriog raphy. The many exceptions to this ruie suggest that cerebral arteriog raphy may be indicated more often than generally believed.
Angiology, Vol. 40, No. 10,
921-928 (1989) |
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