A 55-year-old woman with hypertension presents with sudden severe headache and diplopia. Vital signs show BP 168/98 mmHg, HR 88/min, RR 16/min, temp 37.2°C. Examination reveals right ptosis, right eye deviated down and out, and a dilated poorly reactive right pupil. MRI brain demonstrates a posterior communicating artery aneurysm. There is no neck stiffness or photophobia. She denies recent trauma or anticoagulant use. Which of the following is the most likely cause?
- A)Lesion of the medial longitudinal fasciculus
- B)PICA infarction
- C)Basilar artery thrombosis
- D)Posterior communicating artery aneurysm compressing CN IIIGABARITO
- E)Microvascular ischemic injury to CN VI
Explicação
Posterior communicating artery aneurysm compressing CN III is the correct answer because a painful oculomotor palsy with ptosis, down-and-out eye, and pupillary dilation is classic for a compressive third nerve lesion. Ver explicação completa e trilha adaptativa →