Third (oculomotor) nerve palsy, right eye [H49.01], Reason for Study: ^Reason: partial third nerve palsy History: diplopia, ptosis There is no evidence of acute ischemic lesion.Underlying brain shows diffuse brain atrophy with multifocal patchy T2 high signal intensity lesions on periventricular white matter indicating non specific small vessel ischemic disease. Bilateral basal ganglia and thalami show multiple scattered T2 high signal intensity lesions indicating multiple lacunar infarctions.Bilateral oculomotor nerves are seen without evidence of abnormal signal intensity.Midbrain and periaqueductal gray matter did not show any evidence of abnormal signal intensity on this MRI either.The right 3rd nerve appears to be close proximity to the right SCA on this MRI but its clinical implication is unknown.Although brain MRA was not performed, it does not appear to show evidence of right side posterior communicating artery aneurysm. If clinically indicated, head CTA can be considered for further imaging evaluation.Cranial nerve 4 to 12 are shown bilaterally without definitive evidence of abnormal finding.Bilateral lenses are not seen indicating postoperative status.Deformity of the right eye globe is probably related to senile change.
1. No evidence of acute ischemic stroke. 2. No evidence of abnormal enhancement.3. Close proximity of the right 3rd nerve and right SCA are seen, but its clinical implication is unknown.