Neuro-oph Case 4: Case Continued…

Neuro-oph Case 4 Index

Answer: Given the pupillary changes associated with this motility disturbance, this is an emergency and neuroimaging is obtained.

On CT head with CT angiogram, you see the following:

Above image credit

The radiology report reads:
“There is no evidence of acute ischemic change or hemorrhage. CT angiogram shows an 8 mm aneurysm arising from the origin of the right posterior communicating artery.”  

What’s the most likely diagnosis? Pick 1 before scrolling down.
Myasthenia Gravis
Bell’s palsy
Horner’s syndrome secondary to Pancoast tumor
Horner’s syndrome secondary to cluster headache
Compressive CNIII (Oculomotor nerve) palsy
Ischemic CNIII (Oculomotor nerve) palsy
CNVI (Abducens nerve) palsy
Temporal arteritis
Cavernous sinus thrombosis
Internuclear ophthalmoplegia
Orbital compartment syndrome

What’s the most common life threatening complication of this patient’s presentation? Pick 1 before moving on.
Subarachnoid Hemorrhage
Epidural Hematoma

Click here to move on!

Neuro-oph Case 4 Index

Neuro-oph Case 4: Introduction
Neuro-oph Case 4: Physical Exam