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Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report

INTRODUCTION: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. CASE REPORT: A 69-year-old female presented to the ED with two days...

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Autores principales: Brown, Austin, Jolliff, Heath, Poe, Douglas, Weinstock, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434266/
https://www.ncbi.nlm.nih.gov/pubmed/32926687
http://dx.doi.org/10.5811/cpcem.2020.3.45266
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author Brown, Austin
Jolliff, Heath
Poe, Douglas
Weinstock, Michael
author_facet Brown, Austin
Jolliff, Heath
Poe, Douglas
Weinstock, Michael
author_sort Brown, Austin
collection PubMed
description INTRODUCTION: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. CASE REPORT: A 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology. DISCUSSION: The evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging. CONCLUSION: Some causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm.
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spelling pubmed-74342662020-08-20 Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report Brown, Austin Jolliff, Heath Poe, Douglas Weinstock, Michael Clin Pract Cases Emerg Med Case Report INTRODUCTION: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. CASE REPORT: A 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology. DISCUSSION: The evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging. CONCLUSION: Some causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm. University of California Irvine, Department of Emergency Medicine publishing Western Journal of Emergency Medicine 2020-07-20 /pmc/articles/PMC7434266/ /pubmed/32926687 http://dx.doi.org/10.5811/cpcem.2020.3.45266 Text en Copyright: © 2020 Brown et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Case Report
Brown, Austin
Jolliff, Heath
Poe, Douglas
Weinstock, Michael
Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title_full Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title_fullStr Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title_full_unstemmed Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title_short Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report
title_sort intracavernous internal carotid artery aneurysm presenting as acute diplopia: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434266/
https://www.ncbi.nlm.nih.gov/pubmed/32926687
http://dx.doi.org/10.5811/cpcem.2020.3.45266
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