Pupillary sparing oculomotor palsy from acute subdural hematoma

An acute subdural hematoma presented as a partial third nerve palsy with complete pupillary sparing. The patient was alert and oriented, and except for a subtle hemisensory hypalgesia, there were no other neurologic signs. Preoperative diagnosis was made by CT scan and cerebral angiography. The patient underwent successful craniotomy and within six weeks after surgery, her third nerve palsy had completely resolved.