Concurrent posterior communicating and ophthalmic artery aneurysms in a teenager: diagnostic and endovascular management considerations.
Ayesha Liaqat, Ayesha Khalid, Patrick Ryan
✦ AI-curated · Sources linked
Case in brief
A mid-adolescent boy presented with progressive headaches, blurry vision, and new-onset left eyelid ptosis. Examination revealed a dilated left pupil and cranial nerve III palsy. Initial non-contrast CT was normal, but MR angiography identified a 6 mm lobulated aneurysm at the posterior communicating artery. Endovascular treatment led to gradual neurological recovery.
What made this case unusual
The case underscores the atypical presentation of isolated cranial nerve III palsy as a potential indicator of an unruptured aneurysm in a pediatric patient.
Diagnostic / clinical pearl
Clinicians should consider isolated cranial nerve III palsy as a possible sign of unruptured intracranial aneurysm in adolescents, warranting early vascular imaging.
Why it matters
Recognizing this association can lead to timely diagnosis and management, potentially preventing complications from undetected aneurysms.