[Pupil-sparing painful oculomotor neuropathy due to a carotico-cavernous aneurysm].
BACKGROUND
In third cranial nerve palsy, the lack of mydriasis evokes a noncompressive mechanism. Case report. We report a case of a slightly painful, pure extrinsic third-nerve palsy, complete except for the partial ptosis secondary to the compression by an intracavernous carotid aneurysm. Percutaneous endovascular embolization was followed by complete regression of the palsy within 4 weeks. The pupil may have been spared by the mechanism of compression after the separation of the pupillomotor and extrinsic fibers or the ischemia of the third nerve by its arterial trunk lesion.


CONCLUSIONS
This case report underlines that brain radiological explorations are necessary in some third-nerve pupil-sparing palsies.
Meliksetyan
G
G
Service de Neurologie, Hôpital Foch, Suresnes. gayusha78@yahoo.com
Bourdain
F
F
Rodesch
G
G
Condette-Auliac
S
S
Decroix
J-P
JP
Graveleau
P
P
D000368:Aged; D001763:Blepharoptosis / Q000209:etiology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D002343:Carotid Artery, Internal; D002426:Cavernous Sinus / Q000473:pathology*; D002533:Cerebral Angiography; D004172:Diplopia / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy; D007511:Ischemia / Q000209:etiology; D018810:Magnetic Resonance Angiography; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000209:etiology; D009802:Oculomotor Nerve / Q000098:blood supply; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D011680:Pupil / Q000502:physiology*; D012074:Remission Induction; D013285:Strabismus / Q000209:etiology