Mesencephalic cavernoma causing reversible nuclear third nerve palsy and obstructive hydrocephalus

AKDAL HALMAGYI G., Baklan B., Ersahin Y., Cakmakci H., Yurtseven T., Idiman F.

NEURO-OPHTHALMOLOGY, vol.26, no.2, pp.127-132, 2001 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 2
  • Publication Date: 2001
  • Doi Number: 10.1076/noph.26.2.127.10305
  • Journal Name: NEURO-OPHTHALMOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.127-132
  • Keywords: cavernoma, nuclear third nerve palsy, hydrocephalus, ANGIOMA
  • Dokuz Eylül University Affiliated: Yes

Abstract

We present a case of mesencephalic cavernoma, which caused various interesting clinical symptoms. A 58-year-old man was admitted to the emergency unit with a history of sudden, bilateral ptosis. Neurological examination revealed bilateral ptosis-limited elevation of both eyes, limited depression and adduction of the left eye, and a monocular abducting nystagmus in the right eye. Computed tomography showed a small hematoma in the mesencephalon and magnetic resonance imaging revealed a cavernoma with a hemorrhage. The patient was treated conservatively. Three months later, his bilateral ptosis had resolved and both the depression and the adduction of the left eye had improved. A year later, ocular motility had normalized. He subsequently presented with obstructive hydrocephalus; which was resolved with endoscopic third ventriculostomy.