Third and Sixth Nerve Palsies Due to Cavernous Sinus Meningioma
Creator
Daniel R. Gold, DO
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Third Nerve Palsy; Fourth Nerve Palsy; Sixth Nerve Palsy
Description
This is a 60-year-old woman with a large meningioma that was compressing the right cavernous sinus. Examination demonstrated a pupil-involving right 3rd nerve palsy with near complete external ophthalmoplegia (involving levator palpebrae, medial rectus, superior rectus, inferior rectus). There was also a right partial 6th nerve palsy. With attempted downgaze, incycloduction OD was clearly present, suggestive of intact right 4th nerve function. There was no involvement of V1/V2 on the right face, but she did also have a mild right compressive optic neuropathy from the meningioma.
