Manivannan Susruta, Suresh Vishnu A, Zolnourian Ardalan, Borg Nicholas, Macdonald Jason, Bulters Diederik
Neurosurgery, Southampton General Hospital NHS Foundation Trust, Southampton, GBR.
Neuroradiology, Southampton General Hospital NHS Foundation Trust, Southampton, GBR.
Cureus. 2024 Dec 19;16(12):e76043. doi: 10.7759/cureus.76043. eCollection 2024 Dec.
Peri-mesencephalic subarachnoid haemorrhage (PMSAH) is considered to be a clinically benign subset of subarachnoid haemorrhage (SAH). Cranial nerve palsies have been previously reported as rare sequelae of PMSAH. Herein, we report an unusual case of multiple cranial nerve palsies as a presenting feature of PMSAH and a review of the literature for cranial nerve palsies post-PMSAH. A 60-year-old gentleman was admitted with a sudden onset headache, bilateral oculomotor nerve, and unilateral abducens nerve palsies. CT demonstrated PMSAH, and angiography excluded a structural cause. On longer-term follow-up, he had persistent left-sided oculomotor nerve palsy. To the best of our knowledge, this is the first report of multiple cranial nerve palsies as a presenting feature of PMSAH and demonstrates the possibility of persistent neurological deficit following PMSAH.
中脑周围蛛网膜下腔出血（PMSAH）被认为是蛛网膜下腔出血（SAH）的一种临床良性亚型。此前已有报道称，颅神经麻痹是PMSAH罕见的后遗症。在此，我们报告一例以多发性颅神经麻痹为首发表现的PMSAH罕见病例，并对PMSAH后颅神经麻痹的文献进行综述。一名60岁男性因突发头痛、双侧动眼神经和单侧展神经麻痹入院。CT显示为PMSAH，血管造影排除了结构性病因。在长期随访中，他持续存在左侧动眼神经麻痹。据我们所知，这是首例以多发性颅神经麻痹为PMSAH首发表现的报告，并证明了PMSAH后持续存在神经功能缺损的可能性。
