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Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram

Internal carotid artery dissection (ICAD) is a known but uncommon cause of ischemic stroke among young and middle-aged patients. A common presentation includes ipsilateral headache, unilateral oculosympathetic palsy (partial Horner syndrome), or ischemic stroke but some reported cases present with l...

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Autores principales: Abdelmasih, Randa, Abdelmaseih, Ramy, Monsour, Elio, Reed, Justin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059482/
https://www.ncbi.nlm.nih.gov/pubmed/33898121
http://dx.doi.org/10.7759/cureus.14035
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author Abdelmasih, Randa
Abdelmaseih, Ramy
Monsour, Elio
Reed, Justin
author_facet Abdelmasih, Randa
Abdelmaseih, Ramy
Monsour, Elio
Reed, Justin
author_sort Abdelmasih, Randa
collection PubMed
description Internal carotid artery dissection (ICAD) is a known but uncommon cause of ischemic stroke among young and middle-aged patients. A common presentation includes ipsilateral headache, unilateral oculosympathetic palsy (partial Horner syndrome), or ischemic stroke but some reported cases present with less common manifestations, such as lower cranial nerve syndrome (IX, X, XI, XII). However, third cranial nerve palsy is an extremely rare presentation of ICAD. We present a case of ICAD with pseudoaneurysm presenting with third nerve palsy, with ptosis, outward deviation, and binocular diplopia, emphasizing the importance of considering ICAD as a differential diagnosis in patients with third nerve palsy due to the anatomical proximity of ICA to third nerve within the cavernous sinus.
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spelling pubmed-80594822021-04-23 Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram Abdelmasih, Randa Abdelmaseih, Ramy Monsour, Elio Reed, Justin Cureus Internal Medicine Internal carotid artery dissection (ICAD) is a known but uncommon cause of ischemic stroke among young and middle-aged patients. A common presentation includes ipsilateral headache, unilateral oculosympathetic palsy (partial Horner syndrome), or ischemic stroke but some reported cases present with less common manifestations, such as lower cranial nerve syndrome (IX, X, XI, XII). However, third cranial nerve palsy is an extremely rare presentation of ICAD. We present a case of ICAD with pseudoaneurysm presenting with third nerve palsy, with ptosis, outward deviation, and binocular diplopia, emphasizing the importance of considering ICAD as a differential diagnosis in patients with third nerve palsy due to the anatomical proximity of ICA to third nerve within the cavernous sinus. Cureus 2021-03-22 /pmc/articles/PMC8059482/ /pubmed/33898121 http://dx.doi.org/10.7759/cureus.14035 Text en Copyright © 2021, Abdelmasih et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Abdelmasih, Randa
Abdelmaseih, Ramy
Monsour, Elio
Reed, Justin
Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title_full Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title_fullStr Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title_full_unstemmed Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title_short Isolated Third Nerve Palsy as a Rare and Solo Presentation of Internal Carotid Artery Dissection in a Young Female - a Surprising Finding in the Angiogram
title_sort isolated third nerve palsy as a rare and solo presentation of internal carotid artery dissection in a young female - a surprising finding in the angiogram
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059482/
https://www.ncbi.nlm.nih.gov/pubmed/33898121
http://dx.doi.org/10.7759/cureus.14035
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