Dr. HARITHA V

Dr.VIRNA SHAH

Abstract

We report two cases with bilateral third cranial nerve palsies, one in a 22 years old male who presented with headache and drooping of upper eyelid in both eyes of 5 days duration.He had history of small midbrain cavernoma with VP shunting done in childhood. MRI revealed increase in size of mid brain cavernoma being the cause.

Another patient,a 70 years old male presented with drooping of upperlid in both eyes for 10 days with a history of unconsciousness at the onset (classical of thalamic infarct).MRI showed bilateral acute thalamic infarcts with occlusion of artery of Percheron,a rare variant. Bilateral thalamic infarcts are rarely encountered,observed in 0.6% of ischemic stroke patients. Bilateral oculomotor nerve palsies with pupillary involvement warrant thorough investigation. Here we discuss these 2 cases with two rare etiologies in different age groups.