Perimesencephalic subarachnoid hemorrhage associated with a painless, pupillary-involving third cranial nerve palsy: Case report and literature review

[...]cranial nerve palsy in the setting of PNSH is rare, with only two previous cases documented in the literature [3,4]. [...]though less likely, we cannot exclude the possibility that our patient suffered a radiographically-occult microinfarct to either the midbrain or peripheral portion of the ne...

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Veröffentlicht in:Clinical neurology and neurosurgery 2012-10, Vol.114 (8), p.1168-1171
Hauptverfasser: Reynolds, Matthew R, Vega, Rafael A, Murphy, Rory K.J, Miller-Thomas, Michelle M, Zipfel, Gregory J
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container_end_page 1171
container_issue 8
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container_title Clinical neurology and neurosurgery
container_volume 114
creator Reynolds, Matthew R
Vega, Rafael A
Murphy, Rory K.J
Miller-Thomas, Michelle M
Zipfel, Gregory J
description [...]cranial nerve palsy in the setting of PNSH is rare, with only two previous cases documented in the literature [3,4]. [...]though less likely, we cannot exclude the possibility that our patient suffered a radiographically-occult microinfarct to either the midbrain or peripheral portion of the nerve, although this typically results in a pupillary-sparing third cranial nerve palsy. [...]our MR imaging data do not support this hypothesis given the lack of diffusion restriction in the area of the third cranial nerve nucleus in the midbrain (Fig. 3A).
doi_str_mv 10.1016/j.clineuro.2012.02.028
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[...]though less likely, we cannot exclude the possibility that our patient suffered a radiographically-occult microinfarct to either the midbrain or peripheral portion of the nerve, although this typically results in a pupillary-sparing third cranial nerve palsy. [...]our MR imaging data do not support this hypothesis given the lack of diffusion restriction in the area of the third cranial nerve nucleus in the midbrain (Fig. 3A).</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2012.02.028</identifier><identifier>PMID: 22410651</identifier><identifier>CODEN: CNNSBV</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Aneurysms ; Biological and medical sciences ; Female ; Follow-Up Studies ; Headaches ; Hemorrhage ; Humans ; Magnetic Resonance Angiography ; Medical imaging ; Medical sciences ; Middle Aged ; Neurology ; Neurosurgery ; Non-aneurysmal ; Oculomotor Nerve - diagnostic imaging ; Oculomotor Nerve - pathology ; Oculomotor Nerve Diseases - etiology ; Oculomotor Nerve Diseases - pathology ; Painless ; Paralysis - complications ; Paralysis - pathology ; Perimesencephalic ; Pupil - physiology ; Pupil-involving ; Radiography ; Subarachnoid hemorrhage ; Subarachnoid Hemorrhage - complications ; Subarachnoid Hemorrhage - diagnosis ; Subarachnoid Hemorrhage - diagnostic imaging ; Surgery (general aspects). 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[...]though less likely, we cannot exclude the possibility that our patient suffered a radiographically-occult microinfarct to either the midbrain or peripheral portion of the nerve, although this typically results in a pupillary-sparing third cranial nerve palsy. [...]our MR imaging data do not support this hypothesis given the lack of diffusion restriction in the area of the third cranial nerve nucleus in the midbrain (Fig. 3A).</description><subject>Aneurysms</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Headaches</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Magnetic Resonance Angiography</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>Non-aneurysmal</subject><subject>Oculomotor Nerve - diagnostic imaging</subject><subject>Oculomotor Nerve - pathology</subject><subject>Oculomotor Nerve Diseases - etiology</subject><subject>Oculomotor Nerve Diseases - pathology</subject><subject>Painless</subject><subject>Paralysis - complications</subject><subject>Paralysis - pathology</subject><subject>Perimesencephalic</subject><subject>Pupil - physiology</subject><subject>Pupil-involving</subject><subject>Radiography</subject><subject>Subarachnoid hemorrhage</subject><subject>Subarachnoid Hemorrhage - complications</subject><subject>Subarachnoid Hemorrhage - diagnosis</subject><subject>Subarachnoid Hemorrhage - diagnostic imaging</subject><subject>Surgery (general aspects). 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[...]though less likely, we cannot exclude the possibility that our patient suffered a radiographically-occult microinfarct to either the midbrain or peripheral portion of the nerve, although this typically results in a pupillary-sparing third cranial nerve palsy. [...]our MR imaging data do not support this hypothesis given the lack of diffusion restriction in the area of the third cranial nerve nucleus in the midbrain (Fig. 3A).</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>22410651</pmid><doi>10.1016/j.clineuro.2012.02.028</doi><tpages>4</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland
subjects Aneurysms
Biological and medical sciences
Female
Follow-Up Studies
Headaches
Hemorrhage
Humans
Magnetic Resonance Angiography
Medical imaging
Medical sciences
Middle Aged
Neurology
Neurosurgery
Non-aneurysmal
Oculomotor Nerve - diagnostic imaging
Oculomotor Nerve - pathology
Oculomotor Nerve Diseases - etiology
Oculomotor Nerve Diseases - pathology
Painless
Paralysis - complications
Paralysis - pathology
Perimesencephalic
Pupil - physiology
Pupil-involving
Radiography
Subarachnoid hemorrhage
Subarachnoid Hemorrhage - complications
Subarachnoid Hemorrhage - diagnosis
Subarachnoid Hemorrhage - diagnostic imaging
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Third nerve palsy
title Perimesencephalic subarachnoid hemorrhage associated with a painless, pupillary-involving third cranial nerve palsy: Case report and literature review
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