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J Korean Soc Emerg Med > Volume 30(2); 2019 > Article
Journal of The Korean Society of Emergency Medicine 2019;30(2): 198-204.
동안신경 마비를 동반한 속목동맥 동맥류 증례 2례
김형일 , 최한주
단국대학교 의과대학 응급의학교실
Oculomotor nerve palsy associated with internal carotid artery: case reports
Hyung Il Kim , Han Joo Choi
Department of Emergency Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
Correspondence  Han Joo Choi ,Tel: 041-550-6840, Fax: 041-556-0524, Email: iqtus@hanmail.net,
Received: August 22, 2018; Revised: October 13, 2018   Accepted: October 16, 2018.  Published online: April 30, 2019.
ABSTRACT
Oculomotor nerve palsy limits the specific direction eyeball movement, and represents diplopia, mydriasis, and ptosis. The vascular-associated etiologies of oculomotor nerve palsy are the microvascular ischemia due to hypertension or diabetes, or compression of the nerve by the aneurysm. For the aneurysm, if not treated properly, it may result in mortality or severe neurological impairment. Thorough history taking, physical examinations, and proper imaging modality are needed to make an accurate diagnosis. A 76-year-old female with decreased mentality and anisocoria presented at our emergency department. An 83-year-old female presented with right ptosis and lateral-side deviated of the right eyeball. No definite lesion was noted on the initial non-contrast brain computed tomography (CT) and magnetic resonance imaging diffusion. An aneurysm was detected on CT angiography taken several hours later in the former patient. For the latter patient, a giant aneurysm was detected on magnetic resonance angiography that had been performed at another hospital 4 days earlier. These two patients underwent transfemoral cerebral angiography with coiling. They were discharged with no neurological sequelae.
Key words: Oculomotor nerve diseases; Aneurysm; Internal carotid artery
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