Ducrocq X, Lacour J, Anxionnat R, Marchal C, Bracard S, Vespignani H
Service de Neurologie, Hôpital Central, Nancy, France.
Rev Neurol (Paris). 2000 May;156(5):520-2.
A 63-year-old man presented suddenly and spontaneously an isolated painless oculomotor palsy of the nerve abducens. As no etiology could be suspected a head MRI was performed. It showed a T1 hypersignal of the intracavernous segment of the internal carotid artery with a double-lumen pattern typical of dissection. The patient was treated with aspirin and recovered from clinical symptoms in 10 weeks. A control MRI was performed 3 months after the onset of symptoms and showed the regression of the images of dissection. There was no ischemic lesion of the brain. This case underlines the diversity of the symptoms of spontaneous dissections of cervicocephalic arteries, especially absence of pain, palsies of cranial nerve that are not always limited to lower cranial nerve, and existence of dissections limited to the intracranial segment of the carotid artery. It suggests the interest of MRI in the diagnosis of isolated oculomotor nerve palsies.
一名63岁男性突然自发出现孤立性无痛性展神经动眼神经麻痹。由于未怀疑到病因，遂进行了头部MRI检查。结果显示海绵窦段颈内动脉呈T1高信号，具有典型夹层的双腔模式。患者接受阿司匹林治疗，10周后临床症状恢复。症状发作3个月后进行了对照MRI检查，显示夹层影像消退。脑部无缺血性病变。该病例强调了颈脑动脉自发性夹层症状的多样性，尤其是无疼痛、并非总是局限于低位颅神经的颅神经麻痹，以及局限于颈动脉颅内段的夹层的存在。这表明MRI在孤立性动眼神经麻痹诊断中的价值。
