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:
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.
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
Cavernous sinus thrombosis
Orbital compartment syndrome
What’s the most common life threatening complication of this patient’s presentation? Pick 1 before moving on.
Click here to move on!
Neuro-oph Case 4 Index
Neuro-oph Case 4: Introduction
Neuro-oph Case 4: Physical Exam