gms | German Medical Science

A male came into our ambulance, frightened and in panics. When he woke up, his right eye’s upper eyelid was completely closed, his sight was deemed, and bulbous was rigid.

After a routine examination, complete upper lid ptosis, maximal puil midriasis and divergent eye bulbus position was determined. Virus with stenophenic glass shows 6/6. Camber anterior, iris and inter-ocular pressure were normal. Fundoscopic examination shows two spot bleedings without special significance. Left eye was normal. Complete laboratory analyses, CT and MR brain performed the same day, were normal. Possibly neurotropic virus might caused the nerve oculomotorious paralyses.

Huge vitamin dose, anti-inflammatory and antibiotic therapy was given without results. Another CT brain, this time with contrast shows the right diagnosis. AV malformation of a. carotis post. with 1,5 cm length pushing n. oculomotorious caused the paralyses AV malformation was extracted without interruption of the n .oculomotorious during surgery. Clinical finding was withdrawn after three months rehabilitation.

As a conclusion: CT brain without contrast doesn’t give precise diagnoses concerning the neuro ophtalmology and neurology.