PP430 : An interesting case of multiple cranial nerve palsy

Dr.JAYASRI KRISHNARAJ

A 70 year old female presented with complaints of sudden onset of drooping of left upper eyelid of 2 days duration. There was associated history of headache and altered sensorium .On examination she was ill built and poorly nourished, not oriented and was admitted in ICU. Ophthal examination revealed Left eye complete ptosis and restriction of all movements.Left pupil was dilated and not acting. CT scan revealed pituitary macroadenoma. But clinical presentation was not in favour of it. MDCT scan of Brain and CT angiogram revealed a large partially thrombosed aneurysm 26x33x24 mm arising from cavernous and supraclinoid segment of left internal carotid artery, filling the sella ,left cavernous sinus and extending to the left side of suprasellar cistern. Widening of pituitary fossa was seen but Pituitary was not visualised . She was operated at a higher center. This case is being presented for its rarity and to stress the importance of clinical correlation of radiological diagnosis.