Ismail Mahmoud M, Al Saedi Nasser G, Basamh Omar S, Alsaedi Ali H
Ophthalmology, King Abdullah Medical City, Makkah, SAU.
Cureus. 2025 Feb 18;17(2):e79244. doi: 10.7759/cureus.79244. eCollection 2025 Feb.
Neurological complications following cardiac coronary angiography (CAG), such as ischemic stroke and neuro-ophthalmologic syndromes, are uncommon but significant. This report presents a rare case of isolated third cranial nerve palsy that developed after CAG, highlighting the potential risks associated with the procedure. A 51-year-old male with a history of hypertension and ischemic heart disease underwent CAG for non-ST-segment elevation myocardial infarction. Although the procedure and subsequent cardiac imaging results were normal, the patient developed sudden onset binocular diplopia, ptosis, and restricted eye movements in his left eye following CAG, indicative of left third cranial nerve palsy. Initial computed tomography (CT) and computed tomography angiography (CTA) scans were unremarkable, but a magnetic resonance imaging (MRI) revealed multiple recent lacunar infarcts, including one along the path of the left oculomotor nerve, suggesting an embolic cause. Neuro-ophthalmologic complications post-CAG, though rare, require early detection and intervention, emphasizing the need for preventive measures in at-risk patients.
心脏冠状动脉造影（CAG）后的神经系统并发症，如缺血性中风和神经眼科综合征，虽不常见但后果严重。本报告介绍了1例CAG后发生的罕见孤立性动眼神经麻痹病例，强调了该手术相关的潜在风险。一名有高血压和缺血性心脏病病史的51岁男性因非ST段抬高型心肌梗死接受CAG。尽管手术及随后的心脏成像结果正常，但该患者在CAG后突然出现双眼复视、上睑下垂及左眼眼球运动受限，提示左侧动眼神经麻痹。最初的计算机断层扫描（CT）和计算机断层血管造影（CTA）扫描未见异常，但磁共振成像（MRI）显示多个近期腔隙性梗死灶，其中一个沿左侧动眼神经走行，提示为栓塞原因。CAG后的神经眼科并发症虽罕见，但需要早期检测和干预，强调了对高危患者采取预防措施的必要性。
