Document Detail


Multidetector computed tomographic angiography in isolated third nerve palsy.
MedLine Citation:
PMID:  18280569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate whether multidetector computed tomographic angiography (CTA) scanners can detect a clinically significant intracranial aneurysm in the circle of Willis causing an isolated third nerve palsy (ITNP). DESIGN: Retrospective cross-sectional study. PARTICIPANTS: One hundred thirty-seven patients who presented with an ITNP were examined by multidetector CTA scanners. METHODS: All patients whose symptoms were caused by a compressive cerebral aneurysm were identified. The remaining patients were observed clinically to exclude the possibility of a missed cerebral aneurysm causing the ITNP. No patient underwent diagnostic conventional cerebral angiography (CCA), but all patients who underwent treatment underwent CCA at the time of the treatment. MAIN OUTCOME MEASURES: Accurate identification of a cerebral aneurysm that may cause an ITNP. RESULTS: A cerebral aneurysm causing an ITNP was detected in 27 patients (19.7%). The smallest maximal diameter of a clinically significant aneurysm was 5.7 mm. Of the 27 patients, 25 underwent endovascular coiling at which time CCA confirmed the aneurysm. In no case was another lesion found by CCA. Of the patients without an aneurysm, 81 of 110 (74%) made a complete spontaneous recovery. In no patient was there clinical evidence to suggest that a compressive cerebral aneurysm had been missed on CTA. CONCLUSIONS: Multidetector CTA is a safe and effective diagnostic imaging tool in detecting clinically significant aneurysms when a patient presents with an acute ITNP. We no longer perform CCA to detect a causative aneurysm or determine the type of treatment offered in these patients.
Authors:
Manu R K Mathew; Evelyn Teasdale; Robert M McFadzean
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Publication Detail:
Type:  Journal Article     Date:  2008-02-15
Journal Detail:
Title:  Ophthalmology     Volume:  115     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1411-5     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cerebral Angiography*
Contrast Media
Cross-Sectional Studies
Female
Humans
Image Processing, Computer-Assisted
Intracranial Aneurysm / complications,  radiography*
Iothalamic Acid
Male
Middle Aged
Oculomotor Nerve Diseases / etiology,  radiography*
Retrospective Studies
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 2276-90-6/Iothalamic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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