Acquired, isolated third nerve palsies in infants with cerebrovascular malformations.
OBJECTIVE
To report two infants with acquired, isolated third nerve palsies attributable to intracranial cerebrovascular malformations.


METHODS
Observational case report.


METHODS
Two patients are described. Each was examined in a university-based pediatric ophthalmology and neuro-ophthalmology practice.


RESULTS
An 8-month-old child presented with a pupil-involving partial left third nerve palsy because of a partially thrombosed fusiform aneurysm of the left internal carotid artery. A 3-month-old infant developed a right third nerve palsy from a giant arteriovenous fistula arising from an M2 branch of the right middle cerebral artery.


CONCLUSIONS
Patients younger than 8 months and 3 months with acquired, isolated third nerve palsies resulting from intracranial cerebrovascular malformations could not be found in a MEDLINE search. In conclusion, at even this young age, acquired, isolated third nerve palsies may be the initial manifestation of an intracranial aneurysm or fistula. Magnetic resonance imaging (MRI) and MRI-angiography were adequate for detecting these processes.
Tamhankar
Madhura A
MA
Division of Neuro-ophthalmology, Dept of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Liu
Grant T
GT
Young
Terri L
TL
Sutton
Leslie N
LN
Hurst
Robert W
RW
D001164:Arteriovenous Fistula / Q000151:congenital* / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D011681:Pupil Disorders / Q000209:etiology