Posterior Communicating Artery (PCOM) Aneurysm
Revision as of 16:59, 25 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==")
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
Evaluation
Management
- Emergent BP reduction if hypertensive
- Neuroimaging
- Neurosurgical consult