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Complete third nerve palsy as a presenting feature of an interpeduncular lipoma

Lucy E James¹, Stuart A G Roberts¹, Radu Beltechi¹

¹Department of Neurosurgery, University Hospital, Coventry, England.

British Journal of Neurosurgery

|April 17, 2020

Abstract

Background:

Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies.

Methods:

We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient.

Results:

Following eye patching and steroid treatment, at 6-week follow-up the patient's pain had significantly improved however the complete IIIrd nerve palsy remained.

Conclusions:

Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma.

Keywords:

Interpeduncular lipoma MRI imaging congenital abnormality conservative management intracranial lipoma third nerve palsy

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