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Isolated Pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report
Péricles Maranhão-Filho1, Antonio Aversa Dutra do Souto, Jânio Nogueira
1National Cancer Institute of Rio de Janeiro, and Service of Neurology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Avenida Canal de Marapendi 1680/1802, 22631-050 Rio de Janeiro, RJ, Brazil. pmaranhaofilho@gmail.com
Arquivos De Neuro-Psiquiatria
|April 11, 2007
Summary
A 53-year-old woman experienced double vision due to right superior oblique muscle paresis. This was caused by a dolicoectatic basilar artery compressing the brainstem, a finding revealed by advanced imaging.
Area of Science:
- Neuroscience
- Ophthalmology
- Vascular Neurology
Background:
- Diplopia, or double vision, can significantly impact daily activities and quality of life.
- Superior oblique muscle paresis is a common cause of vertical or torsional diplopia, often presenting with compensatory head postures.
Observation:
- A 53-year-old female presented with a six-month history of diplopia upon downward gaze.
- She adopted a head tilt posture to alleviate symptoms, particularly during reading.
- Neuro-ophthalmic examination revealed isolated right superior oblique muscle paresis.
Findings:
- Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated a dolicoectatic basilar artery.
- The enlarged artery was found to be compressing the right ventral lateral brainstem.
Implications:
- This case highlights a rare cause of isolated superior oblique muscle paresis due to vascular compression.
- Understanding the neurovascular relationships is crucial for diagnosing and managing complex neuro-ophthalmic disorders.
- Non-invasive imaging techniques are vital for identifying structural causes of cranial nerve palsies.
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