| Nonaneurysmal cranial nerve compression as cause of neuropathic strabismus: evidence from high-resolution magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 21861970 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To seek evidence of neurovascular compression of motor cranial nerves (CNs) in otherwise idiopathic neuropathic strabismus using high-resolution magnetic resonance imaging (MRI). DESIGN: Prospective, observational case series. METHODS: High-resolution, surface coil orbital MRI was performed in 10 strabismic patients with idiopathic oculomotor (CN III) or abducens (CN VI) palsy. Relationships between CNs and intracranial arteries were demonstrated by 0.8-mm thick, 162-μm resolution, heavily T2-weighted MRI in fast imaging using steady-state acquisition sequences. Images were analyzed digitally to evaluate cross-sectional areas of extraocular muscles. RESULTS: In one patient with CN III palsy, an ectatic posterior communicating artery markedly flattened and thinned the ipsilateral subarachnoid CN III. Cross-sections of the affected medial, superior, and inferior rectus muscles 10 mm posterior to the globe-optic nerve junction were 17.2 ± 2.5 mm(2), 15.5 ± 1.3 mm(2), and 9.9 ± 0.8 mm(2), significantly smaller than the values of 23.6 ± 1.9 mm(2), 30.4 ± 4.1 mm(2), and 28.8 ± 4.6 mm(2), respectively, of the unaffected side (P < .001). In 2 patients with otherwise unexplained CN VI palsy, ectatic basilar arteries contacted CN VI. Mean cross-sections of affected lateral rectus muscles were 24.0 ± 2.3 mm(2) and 29.8 ± 3.1 mm(2), significantly smaller than the values of 33.5 ± 4.1 mm(2) and 36.9 ± 1.6 mm(2), respectively, in unaffected contralateral eyes (P < .05). CONCLUSIONS: Nonaneurysmal motor CN compression should be considered as a cause of CN III and CN VI paresis with neurogenic muscle atrophy when MRI demonstrates vascular distortion of the involved CN. Demonstration of a benign vascular cause can terminate continuing diagnostic investigations and can expedite rational management of the strabismus. |
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Authors:
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Tzu-Hsun Tsai; Joseph L Demer |
Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2011-09-08 |
Journal Detail:
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Title: American journal of ophthalmology Volume: 152 ISSN: 1879-1891 ISO Abbreviation: Am. J. Ophthalmol. Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-11-23 Completed Date: 2012-01-18 Revised Date: 2012-02-14 |
Medline Journal Info:
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Nlm Unique ID: 0370500 Medline TA: Am J Ophthalmol Country: United States |
Other Details:
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Languages: eng Pagination: 1067-1073.e2 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Jules Stein Eye Institute, University of California, Los Angeles, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abducens Nerve Diseases
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diagnosis,
etiology* Adolescent Adult Cerebral Arterial Diseases / complications* Child Child, Preschool Female Humans Intracranial Aneurysm / pathology Magnetic Resonance Imaging Male Middle Aged Nerve Compression Syndromes / complications* Oculomotor Muscles / pathology Oculomotor Nerve Diseases / diagnosis, etiology* Prospective Studies Strabismus / etiology* Subarachnoid Space Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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EY08313/EY/NEI NIH HHS; P30 EY000331-39/EY/NEI NIH HHS; P30 EY000331-40/EY/NEI NIH HHS; P30 EY000331-41/EY/NEI NIH HHS; P30 EY000331-42/EY/NEI NIH HHS; P30 EY000331-42S1/EY/NEI NIH HHS; P30 EY000331-43/EY/NEI NIH HHS; R01 EY008313-15/EY/NEI NIH HHS; R01 EY008313-16/EY/NEI NIH HHS; R01 EY008313-17/EY/NEI NIH HHS; R01 EY008313-18/EY/NEI NIH HHS; R01 EY008313-19/EY/NEI NIH HHS; R01 EY008313-20/EY/NEI NIH HHS; R01 EY008313-21/EY/NEI NIH HHS; R01 EY008313-22/EY/NEI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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