title: Isolated oculomotor nerve palsy: a rare manifestation of internal carotid artery dissection.
abstract: A 58-year-old man reported sudden-onset binocular double vision that appeared 3 days earlier. He denied history of headache/cervical pain or trauma. He had a medical history of well-controlled diabetes, hypertension and dyslipidaemia. Neurological examination revealed a left-sided ptosis and binocular horizontal diplopia in dextroversion without apparent extraocular-muscle paresis or pupillary involvement. Other cranial nerves were spared as well as motor, sensory and coordination systems. There were no signs of ocular erythema, proptosis or palpable orbital mass. Brain MR angiography revealed a crescent-shaped mural hyperintensity in left internal carotid artery (ICA) at skull base, extending to intrapetrous segment, with reduced calibre and flow, suggesting a left ICA dissection. The patient was started on antiaggregation therapy. A year later he was asymptomatic and CT angiography confirmed ICA recanalisation.
authors.affiliation: Neurology department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Telma
authors.initials: T
authors.lastname: Santos
authors.affiliation: Neurology department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Morais
authors.affiliation: Department of Neuroradiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Oliveira
authors.affiliation: Department of Neuroradiology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Barros
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin