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Double vision in a child.

I A Mehkri¹, S Awner, S E Olitsky

¹Department of Ophthalmology, Children's Hospital of Buffalo, State University of New York at Buffalo, 14222, USA.

Survey of Ophthalmology

|August 31, 1999

Summary

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A rare case of a 10-year-old boy with oculomotor nerve palsy due to an intracranial aneurysm was successfully treated with neurosurgical clipping, highlighting the importance of prompt diagnosis.

Area of Science:

Neuro-ophthalmology
Pediatric Neurology
Neurosurgery

Background:

Oculomotor nerve palsy (cranial nerve III palsy) can be caused by various factors, including vascular compression.
Intracranial aneurysms are rare causes of oculomotor nerve palsy, especially in pediatric populations.

Observation:

A 10-year-old boy presented with acute onset complete left oculomotor nerve palsy.
Diagnostic workup, including neuroimaging and cerebral angiography, identified a small intracranial aneurysm as the causative lesion compressing the third nerve.

Findings:

Neurosurgical intervention involving clipping of the identified intracranial aneurysm led to complete resolution of the oculomotor nerve palsy.
This case underscores the potential for intracranial aneurysms to manifest as oculomotor nerve palsy even in young patients.

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Implications:

The findings emphasize the critical need for thorough diagnostic evaluation in pediatric patients presenting with cranial nerve palsies to rule out serious underlying pathologies like aneurysms.
Early diagnosis and prompt neurosurgical management are crucial for favorable outcomes and preventing long-term neurological deficits in such rare pediatric cases.