scholarly journals Delayed Pneumocephalus-Induced Cranial Neuropathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Neena I. Marupudi ◽  
Monika Mittal ◽  
Sandeep Mittal
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Nerve Compression ◽  
Neurological Deficits ◽  
Oculomotor Nerve Palsy ◽  
Cranial Neuropathy ◽  
Cranial Nerve Deficit ◽  
Moderate Amount ◽  
Interpeduncular Cistern

Pneumocephalus is a common occurrence after cranial surgery, with patients typically remaining asymptomatic from a moderate amount of intracranial air. Postsurgical pneumocephalus rarely causes focal neurological deficits; furthermore, cranial neuropathy from postsurgical pneumocephalus is exceedingly uncommon. Only 3 cases have been previously reported that describe direct cranial nerve compression from intracranial air resulting in an isolated single cranial nerve deficit. The authors present a patient who developed dysconjugate eye movements from bilateral oculomotor nerve palsy. Direct cranial nerve compression occurred as a result of postoperative pneumocephalus in the interpeduncular cistern. The isolated cranial neuropathy gradually recovered as the intracranial air was reabsorbed.

Bevacizumab-induced isolated oculomotor nerve palsy in glioblastoma multiforme

2021 ◽  
pp. 107815522110668
Author(s):  
Ezgi Değerli ◽  
Gülin Alkan ◽  
Nihan Şentürk Öztaş ◽  
Şahin Bedir ◽  
Sümeyra Derin ◽  
...  
Keyword(s):  
Side Effects ◽  
Glioblastoma Multiforme ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Growth Factor Receptor ◽  
Recurrent Glioblastoma ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Recurrent Glioblastoma Multiforme ◽  
Systemic Side Effects

Introduction: Bevacizumab, a monoclonal antibody against the vascular endothelial growth factor receptor, is the standard treatment of recurrent glioblastoma multiforme. In addition to common systemic side effects of bevacizumab, there are rare cases of cranial nerve palsy. Case report: We report a case of transient oculomotor nerve palsy after systemic administration of bevacizumab. Twenty-four hours after the systemic infusion of bevacizumab, transient oculomotor nerve palsy developed in a 49-year-old male patient. In the cranial MRI, there was no malignancy-related progression. Management and outcome: Bevacizumab treatment was discontinued. Methylprednisolone was started considering that bevacizumab increased the inflammatory response. Oculomotor nerve palsy resolved in 14 days. Discussion: There are many side effects of bevacizumab whose mechanisms of action have not been fully explained. Cranial nerve involvement is rarely reported. Our case is the first reported case of bevacizumab-induced oculomotor nerve palsy.

Functional anatomy of headache: circle of Willis aneurysms, third cranial nerve and pain

2011 ◽  
pp. 82-88
Author(s):  
Marcelo Moraes Valença ◽  
Luciana P. A. Andrade-Valença ◽  
Carolina Martins
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Functional Anatomy ◽  
Circle Of Willis ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Microsurgical Anatomy ◽  
Third Nerve Palsy ◽  
The Right ◽  
Third Nerve

Patients with intracranial aneurysm located at the internal carotid artery-posterior communicating artery (ICA-PComA) often present pain on the orbit or fronto-temporal region ipsilateral to the aneurysm, as a warning sign a few days before rupture. Given the close proximity between ICA-PComA aneurysm and the oculomotor nerve, palsy of this cranial nerve may occurduring aneurysmal expansion (or rupture), resulting in progressive eyelid ptosis, dilatation of the pupil and double vision. In addition, aneurysm expansion may cause compression not only of the oculomotor nerve, but of other skull base pain-sensitive structures (e.g. dura-mater and vessels), and pain ipsilateral to the aneurysm formation is predictable. We reviewed the functional anatomy of circle of Willis, oculomotor nerve and its topographical relationships in order to better understand the pathophysiology linked to pain and third-nerve palsy caused by an expanding ICAPComA aneurysm. Silicone-injected, formalin fixed cadaveric heads were dissected to present the microsurgical anatomy of the oculomotor nerve and its topographical relationships. In addition, the relationship between the right ICA-PComA aneurysm and the right third-nerve is also shown using intraoperative images, obtained during surgical microdissection and clipping of an unruptured aneurysm. We also discuss about when and how to investigate patients with headache associated with an isolated third-nerve palsy.

scholarly journals Nasopharyngeal B-cell lymphoma with pan-hypopituitarism and oculomotor nerve palsy: a case report and review of the literature

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maryam Zahedi ◽  
Reyhane Hizomi Arani ◽  
Maryam Tohidi ◽  
Shirin Haghighi ◽  
Masoud Mehrpour ◽  
...  
Keyword(s):  
B Cell ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Oculomotor Nerve ◽  
Diabetic Woman ◽  
Oculomotor Nerve Palsy ◽  
Neoplastic Lesion

Abstract Background Primary nasopharyngeal lymphoma (NPL) is a very rare tumor of Waldeyer ring (WR) lymphoid tissue. It is challenging to differentiate lymphoma infiltration of pituitary from a pituitary adenoma, meningioma infiltration, and other sellar lesions to plan a suitable treatment strategy. We presented for the first time a unique case of NPL with an unusual presentation of oculomotor nerve palsy associated with pan-pituitary involvement in a diabetic patient. Case presentation A 64-year old diabetic woman with no previous history of malignancy presented with intermittent diplopia for about the last nine months. Severe headache, left eye ptosis and hypoglycemic episodes were added to her symptoms after a while. Further complaints include generalized weakness, loss of appetite, generalized musculoskeletal pain, and 6–7 kg weight loss within six months. Her family history was unremarkable. Physical examinations of eyes indicated left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric, and the pupillary reflexes were normal on both eyes. No lymphadenopathy, organomegaly and other abnormalities were found. Magnetic resonance imaging (MRI) showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without bone erosion. Also, both cavernous sinuses were infiltrated and both internal carotid arteries were encased by the neoplastic lesion. It suggested an infiltrative neoplastic lesion which compressed the cranial nerves. Pituitary hormone levels assessment indicated a pan-hypopituitarism. Following nasopharyngeal mucosal biopsy, the immunohistochemistry (IHC) findings revealed a low-grade non-Hodgkin’s B-cell lymphoma. Systemic workup, including cerebrospinal fluid (CSF) studies, bone marrow aspiration, chest and abdominopelvic high-resolution computed tomography (HRCT) indicated no other involvement by the lymphoma. After chemotherapy courses, central adrenal insufficiency, partial central diabetes incipidious (CDI) and central hypothyroidism have been resolved. To our best knowledge, we found 17 cases of NPL with cranial nerve palsy, 1 case of NPL with pan-hypopituitarism and no NPL case with both cranial nerve palsy and pituitary dysfunction. Conclusions The incidence of cranial neuropathy in patients with diabetes should not merely be attributed to diabetic neuropathy without further evaluation.

scholarly journals A rare case of iii cranial nerve palsy - mucormycosis involving the right maxillary and ethmoidal sinus

2021 ◽  
Vol 9 (3) ◽  
pp. 181-184
Author(s):  
K. Praveen Gandhi ◽  
◽  
V. Sakthivel ◽  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Rare Case ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
The Right ◽  
Rule Out

IIIrd Cranial nerve palsy, known as oculomotor nerve palsy, may result from various causes,however, the etiology remains unknown in some instances. This case report aims to present theauthors' experience with a case of IIIrd cranial nerve palsy, together with a review of the literature.Many etiologies have been associated with isolated oculomotor nerve palsies. We report the case ofa patient who presented with right maxillary and ethmoidal sinusitis with IIIrd cranial nerve palsyassociated with mucormycosis. Careful examinations to rule out other causes must be done and thentreatment with antifungals should be considered after early diagnosis.

MRI Findings of Isolated Oculomotor Nerve Palsy after Mild Head Trauma in a Pediatric Patient: Case Report

2021 ◽  
pp. 1-5 ◽  
Author(s):  
Yunjin Im ◽  
Jeong Rye Kim
Keyword(s):  
Nerve Injury ◽  
Head Trauma ◽  
Nerve Palsy ◽  
Brain Mri ◽  
Skull Fracture ◽  
Oculomotor Nerve ◽  
Inversion Recovery ◽  
Neurological Deficits ◽  
Oculomotor Nerve Palsy ◽  
Mri Findings

<b><i>Introduction:</i></b> Traumatic oculomotor nerve injury is usually caused by severe head trauma and is generally associated with other neurological deficits such as basilar skull fracture, orbital injury, or subarachnoid hemorrhage. Isolated traumatic oculomotor nerve injury after minor head trauma and its MRI findings are rarely reported. <b><i>Case Presentation:</i></b> We report a case of a 13-year-old girl with mydriasis, limited inferior and medial movement of the left eyeball, and left ptosis after a mild bump of the left forehead and eye into an electricity pole. The symptoms suggested left oculomotor nerve palsy, but initial facial computed tomography and brain MRI did not reveal any intracranial lesions or fractures in the skull and orbit. Cranial nerve MRI showed segmental hyperintensities and mild thickening of the left oculomotor nerve from the cavernous segment to the proximal orbital segment on T2 short tau inversion recovery and 3D fluid-attenuated inversion recovery volume isotropic turbo spin-echo acquisition sequences. The patient received treatment with oral pyridostigmine for 7 days and was fully recovered at 14 months after injury. <b><i>Discussion:</i></b> As traumatic oculomotor nerve palsy can occur without intracranial hematomas or skull base fractures, routine brain MRI may not always reveal abnormalities; thus, MRI dedicated to imaging of the oculomotor nerve using FS T2WI and high-resolution 3D sequences can be helpful for the diagnosis and management of patients suspected of isolated oculomotor nerve injury.

Sphenoid sinus mucocoele presenting with isolated oculomotor nerve palsy

1997 ◽  
Vol 111 (5) ◽  
pp. 471-473 ◽  
Author(s):  
Dharambir S. Sethi ◽  
David P. C. Lau ◽  
Chumpon Chan
Keyword(s):  
Cranial Nerve ◽  
Sphenoid Sinus ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Ocular Symptoms ◽  
Cranial Nerve Palsies ◽  
Close Relationship ◽  
Relationship Of ◽  
Specific Symptoms

AbstractWe describe two cases of sphenoid sinus mucocoele. Both presented with isolated oculomotor nerve palsy. Mucocoeles involving only the sphenoid sinus are uncommon. They are probably under-diagnosed as they may be asymptomatic or cause non-specific symptoms. Nasal symptoms occur infrequently but the close relationship of the sphenoid sinus to the orbital apex means that ocular symptoms including cranial nerve palsies are a common presenting feature. Involvement of the third cranial nerve in isolation is rare but has important neurosurgical implications which must be excluded before this symptom is attributed to the sphenoid sinus.

scholarly journals Medically Refractory Neuroborreliosis Case Presented with Coexistance Involvements of Cranial 7 and 8 Nerves

2021 ◽  
Vol 13 (1) ◽  
pp. 125-129
Author(s):  
Anam Hareem ◽  
Iman Dabiri ◽  
Nida Zaheer ◽  
Ahmet Z. Burakgazi
Keyword(s):  
Lyme Disease ◽  
Early Diagnosis ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Treatment Resistance ◽  
Neurological Deficits ◽  
Cranial Neuropathy ◽  
Chronic Lyme Disease ◽  
The Us ◽  
Vector Borne

In the US, Lyme disease (LD) has become the most common vector-borne disease. Less than 10% of patients develop cranial nerve palsy or meningitis. There are few reports on cases of Lyme disease with more than one cranial neuropathy. Herein, we will discuss a case of persistent neurological deficits as a result of chronic Lyme disease resistant to standard therapy. Our case is unique due to involvements of cranial seven and eight nerves at the same time. Our case illustrates an extreme example of treatment resistance. However, early diagnosis and prompt establishment of adequate antibiotic treatment are still important to prevent progression to further stages of disease.

scholarly journals Unilateral Oculomotor Nerve Palsy Associated with Leptomeningeal Carcinomatosis and Intracranial Hypertension

2021 ◽  
Vol 39 (4) ◽  
pp. 351-353
Author(s):  
Min-Sub Cho ◽  
Sung-Pa Park ◽  
Jong-Geun Seo
Keyword(s):  
Intracranial Hypertension ◽  
Cancer Cells ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Visual Loss ◽  
Leptomeningeal Carcinomatosis ◽  
Meningeal Carcinomatosis ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Cranial Nerve Palsies

Meningeal carcinomatosis is caused by cancer cells invading the meninges and can cause cranial nerve palsies or intracranial hypertension. Intracranial hypertension can present various symptoms such as headache, visual loss, diplopia and may rarely include unilateral cranial nerve palsy. We report a 57-year-old female with leptomeningeal carcinomatosis and intracranial hypertension who presented as unilateral oculomotor nerve palsy.

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