Departments of Ophthalmology and Visual Sciences and Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Obstet Gynecol. 2021 Apr 1;137(4):682-686. doi: 10.1097/AOG.0000000000004330.
We summarize a case of transient oculomotor nerve palsy in a pregnant woman with a cavernous sinus meningioma. When pregnant women present with acute ophthalmic signs and symptoms, meningioma should be considered during diagnostic workup given the common proximity of growing meningiomas to visual pathways and ocular motor nerves within the parasellar region.
A 32-year-old woman, gravida 2 para 1, at 37 weeks of gestation, presented with 2 weeks of diplopia, left-sided ptosis, and left periocular headache. There were no signs of preeclampsia. Examination revealed a left mydriatic pupil, complete left-sided ptosis, and motility deficits consistent with a left pupil-involving oculomotor nerve palsy. Magnetic resonance imaging of the brain revealed a cavernous sinus meningioma. Five days after cesarean birth, the ptosis significantly improved; 2 weeks later, the diplopia resolved.
Pregnancy is associated with increased likelihood of intracranial meningioma growth, particularly in the parasellar region. We highlight a rare case of a transient cranial nerve III palsy in a pregnant patient due to cavernous sinus meningioma and review prior published reports.
我们总结了一例伴有海绵窦脑膜瘤的孕妇动眼神经麻痹。当孕妇出现急性眼部体征和症状时，鉴于生长中的脑膜瘤与视路和鞍旁区域的眼运动神经通常相邻，在诊断过程中应考虑脑膜瘤。
一位 32 岁女性，妊娠 2 产 1，孕 37 周，出现 2 周复视、左侧上睑下垂和左侧眶周头痛。无先兆子痫迹象。检查发现左侧瞳孔散大，完全性左侧上睑下垂，运动障碍与累及左侧瞳孔的动眼神经麻痹一致。脑部磁共振成像显示海绵窦脑膜瘤。剖宫产分娩 5 天后，上睑下垂明显改善；2 周后，复视缓解。
妊娠与颅内脑膜瘤生长的可能性增加有关，尤其是在鞍旁区域。我们强调了一例因海绵窦脑膜瘤导致的罕见孕妇颅神经 III 麻痹的病例，并回顾了先前发表的报告。
