Dr.Ashwita Nair

Dr.Rajalakshmi A.R. , Dr. Ishan Tilak, Dr.Rajalakshmi A.R.

Abstract

Third nerve palsy has a variety of etiologies and can be a harbinger of serious pathology most likely to be vascular event (ischemic or compressive), tumor or demyelination. We are reporting a case of unilateral isolated pupil involving third cranial nerve palsy. The patient presented with complete drooping of right upper eyelid involving the pupil along with extraocular movement restriction but without papilledema even though the initial investigations (MRI) showed idiopathic intracranial hypertension. However a week later when the symptoms did not subside a detailed cuts of CT Brain showed hyperdense saccular aneurysmal dilatation in right posterior communicating artery which was missed in the initial investigations. An early diagnosis would have been much helpful for the patient.