Posterior Communicating Artery (PCOM) Aneurysm: Difference between revisions
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Revision as of 14:14, 22 March 2016
Background
- Acute CN III palsy with ipsilateral pupil dilation is PCOM aneurysm until proven otherwise
- Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation
- In contrast to CN III palsy due to DM or HTN in which pupil is spared
Clinical Features
- Inhibition of ipsilateral medial gaze, upward gaze, downward gaze, ptosis
- Lateral gaze (abduction) is preserved
- Ipsilateral dilated pupil
Differential Diagnosis
Diagnosis
Treatment
- Emergent BP reduction if hypertensive
- Neuroimaging
- Neurosurgical consult