Tamhankar Madhura A, Liu Grant T, Young Terri L, Sutton Leslie N, Hurst Robert W
Division of Neuro-ophthalmology, Dept of Neurology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Am J Ophthalmol. 2004 Sep;138(3):484-6. doi: 10.1016/j.ajo.2004.03.023.
To report two infants with acquired, isolated third nerve palsies attributable to intracranial cerebrovascular malformations.
Observational case report.
Two patients are described. Each was examined in a university-based pediatric ophthalmology and neuro-ophthalmology practice.
An 8-month-old child presented with a pupil-involving partial left third nerve palsy because of a partially thrombosed fusiform aneurysm of the left internal carotid artery. A 3-month-old infant developed a right third nerve palsy from a giant arteriovenous fistula arising from an M2 branch of the right middle cerebral artery.
Patients younger than 8 months and 3 months with acquired, isolated third nerve palsies resulting from intracranial cerebrovascular malformations could not be found in a MEDLINE search. In conclusion, at even this young age, acquired, isolated third nerve palsies may be the initial manifestation of an intracranial aneurysm or fistula. Magnetic resonance imaging (MRI) and MRI-angiography were adequate for detecting these processes.
报告两例因颅内脑血管畸形导致获得性孤立性动眼神经麻痹的婴儿。
观察性病例报告。
描述了两名患者。每名患者均在大学附属医院的儿科眼科和神经眼科诊所接受检查。
一名8个月大的儿童因左侧颈内动脉部分血栓形成的梭形动脉瘤出现累及瞳孔的左侧动眼神经部分麻痹。一名3个月大的婴儿因右侧大脑中动脉M2分支的巨大动静脉瘘出现右侧动眼神经麻痹。
通过医学文献数据库检索未发现年龄小于8个月和3个月因颅内脑血管畸形导致获得性孤立性动眼神经麻痹的患者。总之，即使在这个年龄阶段，获得性孤立性动眼神经麻痹也可能是颅内动脉瘤或瘘的首发表现。磁共振成像（MRI）和磁共振血管造影足以检测出这些病变。
