A 83-years-old female presented with the left ptosis and pupillary defect. We detected oculomotor palsy in the left eye as the sole pathological findings, She developed diplopia 16 days later. Spontaneous dural arterio-venous fistula in the cavernous sinus of Barrow type D was detected by carotid angiography. Embolization for the fistula was carried out. Mechanism of oculomotor palsy can be ischemia or direct compression on the nerve. Pupillary fiber occupies the lower nasal part of oculomotor nerve in the cavernous sinus, therefore it is not likely to be damaged by ischemic process in this case. On the other hand, it is likely to be disturbed by compression liko a mechanism seen in a patient with IC-PC aneurysm. The present case is somewhat unusual because oculomotor palsy presented as ptosis and pupillary abnormality was a first sign of spontaneous dural arteriovenous fistula.
|出版物ステータス||Published - 1993 12 1|
ASJC Scopus subject areas
- Clinical Neurology