title: True- true- unrelated? A delayed onset, complete third-nerve palsy after traumatic subarachnoid hemorrhage.
abstract: A 61-year-old male presented to the emergency department (ED) with painless diplopia, left-ptosis, and left downward gaze, 3 days after sustaining a fall from standing height with subsequent lumbar and head trauma. Prior to the ED consult, his only symptom was persistent generalized high intensity headache. On physical examination, no other neurological deficit was found. Computed tomography (CT) scan showed Fisher 4 subarachnoid hemorrhage (SAH). Cerebral angiogram and brain magnetic resonance imaging (MRI) were negative. Screening for possible secondary causes of isolated third-nerve palsy (TNP) were all negative. To our knowledge, this is the first report of a traumatic SAH with delayed onset of an isolated complete TNP as its manifestation.
  None pertinent to this research.
  All authors have provided original or professional content and were involved in the clinical care of the patient.
  CNcranial nerveDSAdigital subtraction angiogramGCSGlasgow Coma ScalePCOMposterior communicating arterySAHsubarachnoid hemorrhageTNPthird nerve palsytSAHtraumatic SAH.
authors.affiliation: Pontificia Universidad Javeriana, Bogota, Colombia.
authors.forename: Maria Daniela
authors.initials: MD
authors.lastname: Silva
authors.forename: Paul
authors.initials: P
authors.lastname: Brazis
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Robert
authors.initials: R
authors.lastname: Wharen
authors.forename: Christina C
authors.initials: CC
authors.lastname: Smith
authors.forename: William David
authors.initials: WD
authors.lastname: Freeman
keywords: complete third-nerve palsy; hemorrhage; subarachnoid