Article Text

PDF
A challenging case of double vision and altered facial sensation
  1. Suvankar Pal,
  2. Jane Halliday,
  3. Richard J Davenport,
  4. Peter Keston
  1. Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK
  1. Correspondence to Dr P Keston, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK; Peter.keston{at}luht.scot.nhs.uk

Statistics from Altmetric.com

A 59-year-old woman noticed gradual onset of double vision on left lateral gaze in 2006. Over the following year, symptoms of a drooping right eyelid, double vision on right lateral gaze and altered sensation around the right eye emerged, together with pain behind the right eye. The only other significant background was a 40 pack year smoking history. Examination revealed bilateral VI nerve palsies, excoriation over the right forehead reflecting diminished trigeminal ophthalmic nerve sensation and partial right ptosis with impaired pupillary light response (figure 1A). CT of the brain revealed large bilateral carotid aneurysms (figure 1B,C). Further investigation with CT and catheter angiography confirmed the presence of bilateral giant cavernous internal carotid artery (ICA) aneurysms and a smaller right posterior communicating artery aneurysm (figure …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.