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Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage

We present a case series of two patients who developed unilateral cranial nerve III (CNIII) palsy following non-aneurysmal SAH (NASAH). Subarachnoid hemorrhage (SAH) can present with various signs and symptoms. Early diagnosis is paramount to determine treatment course. Thus, clinicians must be awar...

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Autores principales: Mehta, Shyle, Bathini, Abhijith, Dubey, Anwesha, Barpujari, Awinita, Kassem, Ahmad, Sulaiman, Mohanad, Binning, Mandy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537643/
https://www.ncbi.nlm.nih.gov/pubmed/35316881
http://dx.doi.org/10.7461/jcen.2022.E2021.06.007
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author Mehta, Shyle
Bathini, Abhijith
Dubey, Anwesha
Barpujari, Awinita
Kassem, Ahmad
Sulaiman, Mohanad
Binning, Mandy
author_facet Mehta, Shyle
Bathini, Abhijith
Dubey, Anwesha
Barpujari, Awinita
Kassem, Ahmad
Sulaiman, Mohanad
Binning, Mandy
author_sort Mehta, Shyle
collection PubMed
description We present a case series of two patients who developed unilateral cranial nerve III (CNIII) palsy following non-aneurysmal SAH (NASAH). Subarachnoid hemorrhage (SAH) can present with various signs and symptoms. Early diagnosis is paramount to determine treatment course. Thus, clinicians must be aware of the variable clinical presentations of this condition. Two patients were admitted to a single institution for SAH. Patient 1, 52-year-old male, presented with headache, left eye ptosis, and painless diplopia. A non-contrast head computed tomography (CT) demonstrated a SAH within the left sylvian fissure and blood surrounding the mesencephalon and falx. Patient 2, 70-year-old male, presented with mild headache, acute onset of blurry vision, and right eye ptosis. A non-contrast head CT demonstrated a diffuse SAH predominantly in the Sylvian and suprasellar cisterns. Patients were admitted to the neuro intensive care unit and underwent diagnostic angiograms to identify possible aneurysms. Magnetic resonance imaging and angiograms for both patients were negative. Patients were managed with best medical therapy and followed up in the outpatient setting. Unilateral CNIII palsy in the setting of NASAH was identified in both patients. Diagnostic angiograms were negative for aneurysms; therefore, SAH were determined to be spontaneous. We propose that unilateral CNIII palsy is a possible sign of NASAH.
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spelling pubmed-95376432022-10-17 Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage Mehta, Shyle Bathini, Abhijith Dubey, Anwesha Barpujari, Awinita Kassem, Ahmad Sulaiman, Mohanad Binning, Mandy J Cerebrovasc Endovasc Neurosurg Case Report We present a case series of two patients who developed unilateral cranial nerve III (CNIII) palsy following non-aneurysmal SAH (NASAH). Subarachnoid hemorrhage (SAH) can present with various signs and symptoms. Early diagnosis is paramount to determine treatment course. Thus, clinicians must be aware of the variable clinical presentations of this condition. Two patients were admitted to a single institution for SAH. Patient 1, 52-year-old male, presented with headache, left eye ptosis, and painless diplopia. A non-contrast head computed tomography (CT) demonstrated a SAH within the left sylvian fissure and blood surrounding the mesencephalon and falx. Patient 2, 70-year-old male, presented with mild headache, acute onset of blurry vision, and right eye ptosis. A non-contrast head CT demonstrated a diffuse SAH predominantly in the Sylvian and suprasellar cisterns. Patients were admitted to the neuro intensive care unit and underwent diagnostic angiograms to identify possible aneurysms. Magnetic resonance imaging and angiograms for both patients were negative. Patients were managed with best medical therapy and followed up in the outpatient setting. Unilateral CNIII palsy in the setting of NASAH was identified in both patients. Diagnostic angiograms were negative for aneurysms; therefore, SAH were determined to be spontaneous. We propose that unilateral CNIII palsy is a possible sign of NASAH. Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 2022-09 2022-03-23 /pmc/articles/PMC9537643/ /pubmed/35316881 http://dx.doi.org/10.7461/jcen.2022.E2021.06.007 Text en Copyright © 2022 by KSCVS and KoNES https://creativecommons.org/licenses/by-nc/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mehta, Shyle
Bathini, Abhijith
Dubey, Anwesha
Barpujari, Awinita
Kassem, Ahmad
Sulaiman, Mohanad
Binning, Mandy
Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title_full Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title_fullStr Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title_full_unstemmed Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title_short Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
title_sort isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9537643/
https://www.ncbi.nlm.nih.gov/pubmed/35316881
http://dx.doi.org/10.7461/jcen.2022.E2021.06.007
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