ptosis-2

Mrs P,a 44 year old female,came to the emergency room complaining of severe headache.She describing the pain as sharp and shooting into the front of her head,then aching.She allso says that her left eye wants to stay shut.She has had this pain on and off for five days.Four days ago,she saw her family physician who ordered a CT of the head.This shown no abnormlities.

Her physical exam was unremarkable.Blood pressure was 131/79mmHg with resting heart rate 97 beat/minute.

other systems reveal normal except;

• she has weak upward and medial movement of the left eye.On foward gaze,the eye is deviated down and laterally. There is mild ptosis of the left eyelid
• the left pupil was larger than the right.The left eye did not react to light either direct or consensual.The right pupil responses was normal.

provisional diagnosis: posterior communicating artery aneurysm

please refer to X'PRESS revision in short cases by Universiti Malaya,page 8,approach to ptosis.please understand how Horner's syndrome,diabetes mellitus and PCOM aneursym can cause unilateral ptosis but different pupil size.

[happy study]

this short case was prepared by my studygroup mate,faten aqilah.please ask this makcik for better uderstanding.Jangan stress ye~~~~~~~~~