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Related Experiment Videos

Negative MRI versus real disease

D A Weinberg1

  • 1Division of Ophthalmology, University of Vermont School of Medicine, Burlington, USA.

Survey of Ophthalmology
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

A diabetic patient experienced sudden vision changes due to a posterior communicating artery aneurysm. Conventional angiography confirmed the aneurysm, highlighting its importance in diagnosing such critical vascular conditions.

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Area of Science:

  • Neuro-ophthalmology
  • Vascular Neurology
  • Medical Imaging

Background:

  • Third cranial nerve palsy can be caused by aneurysms.
  • Posterior communicating artery aneurysms are a critical diagnosis.
  • Diabetic patients may present with atypical neurological symptoms.

Observation:

  • A 76-year-old diabetic woman presented with progressive vertical diplopia and right eye pain.
  • Examination revealed a pupil-involving partial right third cranial nerve palsy and anisocoria.
  • Magnetic Resonance Angiography (MRA) initially failed to identify a 1 cm right posterior communicating artery aneurysm.

Findings:

  • Subsequent conventional cerebral angiography definitively detected the 1 cm right posterior communicating artery aneurysm.
  • MRA sensitivity for aneurysm detection can vary, with some centers reporting high sensitivity and others less favorable data.

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  • Standardized MRA protocols and meticulous interpretation are crucial for accurate aneurysm detection.

    • Implications:

    • Conventional angiography remains the gold standard for detecting cerebral aneurysms.
    • MRA shows significant potential for non-invasive aneurysm detection with optimized protocols.
    • Accurate and timely diagnosis of posterior communicating artery aneurysms is vital for preventing catastrophic outcomes.