ISSN: 1300-0365
Dil: Türkçe
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İzole Okülomotor Sinir Felcinde Nöroradyolojik İnceleme Endikasyonları
Hülya Nurgün ORER*, David I. Kaufman** ,Eric EGGENBERGER*** , Sunay Duman****
* Uzm.Dr. SB Ankara Hastanesi Göz Kliniği , ANKARA** Assoc. Prof. Michigan State University Neure-Visual Unit, Michigan, USA***. Asist. Prof.Michigan State University Neure-Visual Unit, Michigan, USA****Dr.SB Ankara Hastanesi Göz Kliniği, Şefi, ANKARA
Determining the indications for neuroimaging in isolated oculomotor nerve palsy was objected in this study. 27 patients with isolated oculomotor nerve palsy were studied by either computerized tomography (CT, 5 patients) or magnetic resonance imaging (MRI, 22 patients). 14 patients had additional cerebral angiography. The indications for angiography were the presence of iridoplegia alone (4 patients), iridoplegia accompanied by neuroimaging suggestive of aneurysm on CT (1 patient) and on MRI (1 patient), normal pupil accompanied by neuroimaging suggestive of aneurysm on MRI (2 patients), and severe peri/retroorbital pain (6 patients).
No CT/MRI showed tumor impinging on the oculomotor nerve. Internal carotid artery-posterior communicating artery junctional aneurysm was diagnosed in 4 angiographies; the indications for these angiographies were the presence of iridoplegia alone (1 patient), iridoplegia accompanied by neuroimaging suggestive of aneurysm on CT (1 patient), iridoplegia accompanied by neuroimaging suggestive of aneurysm on MRI (1 patient), and normal pupil accompanied by neuroimaging suggestive of aneurysm on MRI (1 patient, this patient eventually developed iridoplegia). The angiography of the second patient with normal pupil accompanied by neuroimaging suggestive of aneurysm on MRI did not show an aneurysm (the patient’s pupil remained normal). No aneurysm was seen on the angiographies performed due to the presence of severe peri/retroorbital pain.
Since no tumor or aneurysm was observed in patients with normal pupil, while all patients with aneurysm showed iridoplegia we conclude that iridoplegia is an indication for neuroimaging. We suggest that all patients with iridoplegia have CT or MRI, and if no tumor is observed, irrespective of the presence or absence of neuroimaging suggestive of aneurysm, followed by cerebral angiography.Keywords: Oculomotor nerve palsy, Intracranial aneurysm, Cerebral angiography, Computerised tomography, Magnetic resonance imagingTurkiye Klinikleri Oftalmoloji 1997, 6:229-232
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