Computerized tomography angiography in isolated third nerve palsies.
OBJECTIVE
The goal of this study was to assess the value of computerized tomography (CT) angiography as a diagnostic tool in isolated oculomotor nerve palsies.


METHODS
One hundred consecutive patients who presented with an isolated third nerve palsy were examined by CT angiography. This procedure was followed by conventional cerebral angiography in most patients in whom a vascular abnormality was noted on the CT angiography. Thus, all patients whose symptoms were caused by a compressive aneurysm were identified. The remaining patients were observed clinically to exclude the possibility that a missed cerebral aneurysm caused the isolated third nerve palsy. Eighteen patients harbored a cerebral aneurysm responsible for causing the isolated third nerve palsy. Most of the remaining patients experienced some degree of spontaneous recovery. There was no clinical evidence to indicate that a case of compressive cerebral aneurysm causing the isolated third nerve palsy had been missed on CT angiography.


CONCLUSIONS
Computerized tomography angiography is a reliable diagnostic tool for use in the assessment of patients with an isolated third nerve palsy; it can identify the minority of patients in whom conventional cerebral angiography may be required.
McFadzean
R M
RM
Department of Neuroophthalmology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, Scotland.
Teasdale
E M
EM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed