A 52-year-old woman with hypertension develops sudden severe retro-orbital headache followed by diplopia. Vital signs: BP 168/98 mmHg, HR 92/min, RR 16/min, temp 37.2°C. Examination reveals the right eye positioned down and out with ptosis and a dilated nonreactive pupil. Fundoscopy shows no papilledema. CT head without contrast is normal. She denies recent trauma or fever. Which of the following is the most likely cause?
- A)Cavernous sinus thrombosis
- B)Pontine hemorrhage
- C)Microvascular ischemia from diabetes mellitus
- D)Posterior communicating artery aneurysm compressing cranial nerve IIIGABARITO
- E)Pituitary prolactinoma
Explicação
Posterior communicating artery aneurysm compressing cranial nerve III is correct. Compressive third nerve palsy causes ptosis, down and out eye deviation from unopposed lateral rectus and superior oblique action, and pupil dilation because the superficial para... Ver explicação completa e trilha adaptativa →