Welcome to this month’s What’s Your Diagnosis Challenge!
Case Presentation: An Evidence-Based Approach to Abnormal Vision
A 40-year-old woman is brought in to the ED by her husband, complaining of blurred vision and dizziness. She said she had visited an urgent care clinic last week with a new diagnosis of migraine headache. Her examination is remarkable for right eyelid ptosis, limited movement of the right eye to left gaze, and a right dilated pupil compared to the left.
Her husband comments that his brother ?had the same thing with his diabetes,? and asks you to check her sugar, but you think something else might be going on…
You determined that your patient, who had complained of ?blurred vision and dizziness,? had diplopia, not blurred vision, and a CN III palsy, suggesting an aneurysm, likely of the posterior communicating artery. A CTA of the head confirmed this, and you consulted neurosurgery. Your patient was admitted for intervention.
Review this issue to find out more of the authors’ recommendation.
Not a subscriber? You can find out the conclusion and if you got it right, next month when a new case is posted, so stay tuned!
Last Updated on July 9, 2020