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Ocular motor paralysis and arachnoid cyst
Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1980
Summary
A racquetball eye injury preceded third nerve paralysis in a woman. Surgical decompression of an interpeduncular fossa arachnoid cyst resolved the paralysis, highlighting a rare cause of oculomotor nerve palsy.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurosurgery
Background:
- The third cranial nerve (oculomotor nerve) controls most eye movements and eyelid opening.
- Traumatic injuries can affect cranial nerve function, but direct trauma to the nerve is uncommon.
- Arachnoid cysts are congenital collections of cerebrospinal fluid that can cause mass effect.
Observation:
- A 32-year-old woman presented with right third nerve paralysis four days after direct trauma to her right eye from a racquetball.
- Neuroimaging revealed an arachnoid cyst in the interpeduncular fossa.
Findings:
- The arachnoid cyst was causing mass effect, leading to compression of the right third cranial nerve.
- Surgical decompression of the arachnoid cyst resulted in complete resolution of the third nerve paralysis.
Implications:
- This case suggests that even seemingly minor head trauma can unmask or exacerbate underlying structural abnormalities like arachnoid cysts.
- Interpeduncular fossa arachnoid cysts should be considered in the differential diagnosis of third nerve palsies, particularly following head trauma.
- Surgical intervention for symptomatic arachnoid cysts can effectively reverse neurological deficits such as oculomotor nerve palsy.