Fourth nerve palsy, homonymous hemianopia, and hemisensory deficit caused by a proximal posterior cerebral artery aneurysm.
A 21-year-old man developed an ipsilateral fourth nerve palsy, contralateral hemianopia, and contralateral hemisensory deficit as manifestations of a proximal right posterior cerebral artery aneurysm. This unusual constellation of signs reflects the involvement of the structures that run in the ambient cistern. The fourth nerve palsy and homonymous hemianopia are attributed to compression by the aneurysm. The hemisensory loss is ascribed to compromise of thalamoperforate arteries emanating from a thrombosed portion of the aneurysm.
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
Jennifer K
JK
Hall
Dina A
DA
Jacobs
Tammy
T
Movsas
Steven L
SL
Galetta
D000328:Adult; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D006423:Hemianopsia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D020767:Intracranial Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020432:Trochlear Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D058609:Visual Field Tests; D014794:Visual Fields