Posterior Communicating Artery (PCOM) Aneurysm: Difference between revisions
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*Acute [[CN III palsy]] with ipsilateral pupil dilation is PCOM aneurysm until proven otherwise | *Acute [[CN III palsy]] with ipsilateral pupil dilation is PCOM aneurysm until proven otherwise | ||
**Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation | **Aneurysm compresses the outer fibers (pupillomotor) of CN III -> dilation | ||
**In contrast to CN III palsy due to DM or | **In contrast to CN III palsy due to DM or hypertension in which pupil is spared | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 10:38, 31 July 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 hypertension 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
Evaluation
Management
- Emergent BP reduction if hypertensive
- Neuroimaging
- Neurosurgical consult