Which of these can cause 3rd nerve paralysis
A i.e. Posterior communicating aery aneurysm; B i.e. Tolosa Hunt Syndrome; C i.e. Midbrain infarct 3rd nerve palsy Causes Site Pathology Clinical features Midbrain Infarct Q, haemorrhage, demylination, infection, tumor Contralateral pyramidal signs, may be bilateral, may not affect pupil Circle of Aneurysm of posterior Pupil Willis communicating aery involvement is Q & basilar aery early Subarachnoid space Aneurysm, infarct, compression, tumor, meningitis Cavernous Internal carotid aery IV,,, & Vth nerve sinus aneurysm, carotid- also involved +- cavernous fistula, cavernous sinus thrombosis, tumors pain & proptosis of eye (pituitary adenoma, Meningioma, metastasis), herpes zoster, Tolosa-Hunt syndrome Q Orbit Infarction of nerve e.g. Pupils often diabetes, giant cell aeritisQ sparedQ Syndromes Midbrain syndromes Name Site Feature Nothnagel's Superior I/L 3rd syndrome cerebellar nerve palsy peduncle C/L cerebellar ataxia Benedikt's Red I/L 3rd syndrome nucleus nerve palsy C/ L tremor, chorea, & athetosis Claude's Superior Combined syndrome cerebellar of above peduncle two + Red nucleus Weber's Cerebral I/L 3rd syndrome peduncle nerve palsy C/L hemiparesis
Posterior communicating aery (PCA) aneurysm
Tolosa-Hunt syndrome
Midbrain infarct
All