Oculomotor Nerve Palsy - Thrombosed Cavernoma
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0478-Oculomotor Nerve Palsy - Thrombosed Cavernoma
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CA0478-Oculomotor Nerve Palsy - Thrombosed Cavernoma
Case ReportHistory
Exam
Prior Study
Findings
Brain and Brainstem
The region of the third cranial nerve nucleus in the brainstem is normal; however, the respective tract of cranial nerve 3 within the brainstem to the root entry zone is abnormal. This area shows minimal increased signal intensity on T1-weighted images without contrast, mixed signal intensity on FLAIR and T2-weighted images, and minimal enhancement. It demonstrates some minimal localized mass effect without surrounding edema. Specific susceptibility weighted imaging was not done but the diffusion weighted sequence shows susceptibility effects consistent with the presence of blood products.
The root entry zone the third cranial nerve within the left middle cerebral peduncle is also abnormal on the left side as just described.
General Meninges, Cisternal Segment and Root Entry Zone
Generalized abnormal meningeal (dural and/or pia-arachnoid) enhancement is not present; however, the pia/arachnoid surface at the root exit zone of the third nerve shows minimal abnormal enhancement. There is no abnormal enhancement and/or enlargement of the cisternal segment of the third cranial nerve.
There is no structural abnormality including a posterior communicating or other cerebral aneurysm along the cisternal segment of the third cranial nerve.
Cavernous sinus and Paracavernous Structures and Central Skull Base
There is no abnormal enhancement and/or enlargement or structural abnormality along he 3rd, 4th or 6th cranial nerve in the cavernous sinus or paracavernous region.
Orbit, Extraocular Muscles, Sinonasal Region and Related Skull Base
The orbital apex and superior orbital fissure appear normal. The extraocular muscles appear normal.
