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Spontaneous resolution of aneurysmal third nerve palsy
Rod Foroozan1, Thomas L Slamovits, Susan M Ksiazek
1Neuro-Ophthalmology Service, Wills Eye Hospital, Thomas Jefferson University, 900 Walnut Street, Philadelphia, PA 19107, USA. rforoozan@hotmail.com
Summary
Third cranial nerve palsy during pregnancy, caused by an aneurysm, resolved spontaneously after delivery. This case highlights that complete resolution doesn't rule out an underlying aneurysm.
Area of Science:
- Neuroscience
- Vascular Neurology
- Obstetrics
Background:
- Third cranial nerve palsy (oculomotor nerve palsy) can arise from various causes, including aneurysms.
- Pregnancy presents unique challenges for managing neurological conditions due to physiological changes and potential risks to mother and fetus.
Observation:
- A 33-year-old pregnant woman in her third trimester developed third cranial nerve palsy.
- The palsy was attributed to compression from a posterior communicating artery aneurysm.
- Surgical intervention was deferred due to prepartum complications.
Findings:
- The patient underwent cesarean section delivery.
- Following delivery, the third cranial nerve palsy resolved spontaneously within 3 weeks.
- Follow-up angiography indicated a reduction in the size of the aneurysmal sac.
Implications:
- Spontaneous resolution of third nerve palsy does not preclude an underlying posterior communicating artery aneurysm.
- This case underscores the importance of continued monitoring and investigation even after apparent recovery.
- Management of neurological deficits during pregnancy requires careful consideration of maternal and fetal well-being.