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==Background==
==Background==
*Acute CN III palsy w/ ipsilateral pupil dilation is PCOM aneurysm until proven otherwise
*Acute [[CN III palsy]] with ipsilateral pupil dilation is PCOM aneurysm until proven otherwise
**Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation
**Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation
**In contrast to CN III palsy due to DM or HTN in which pupil is spared
**In contrast to CN III palsy due to DM or HTN in which pupil is spared

Revisión del 07:33 6 jun 2015

Background

  • Acute CN III palsy with ipsilateral pupil dilation is PCOM aneurysm until proven otherwise
    • Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation
    • In contrast to CN III palsy due to DM or HTN in which pupil is spared

Clinical Features

  • Inhibition of ipsilateral medial gaze, upward gaze, downward gaze, ptosis
    • Lateral gaze (abduction) is preserved
  • Ipsilateral dilated pupil

Differential Diagnosis

Diagnosis

Treatment

  • Emergent BP reduction if hypertensive
  • Neuroimaging
  • Neurosurgical consult

Disposition

References