![]() clipping, coiling, and/or endovascular embolization). In cases of CNIII palsy caused by intracranial aneurysms, recovery of CNIII function usually occurs for those who undergo neurosurgical intervention (i.e. Symptoms that are present after six months usually persist over time. Signs and symptoms of CNIII deficits usually recover over a period of weeks to months. Another common cause of CNIII palsy is brain stem ischemia and trauma, usually due to severe head blows. In fact, an isolated CNIII palsy is one of the clinical hallmarks of a PCoA aneurysm. Isolated cranial nerve III (CNIII) palsy in the setting of SAH is most commonly seen secondary to compression by intracranial aneurysm, especially those of the posterior communicating artery (PCoA), internal carotid artery, and basilar artery. A stat head computed tomography (CT) should be done if SAH is suspected. As such, physicians must be aware of the diverse clinical presentations of SAH. A quick and early diagnosis is paramount in determining an effective course of treatment. Subarachnoid hemorrhage (SAH) is caused by multiple etiologies and can present with various signs and symptoms. Subarachnoid Hemorrhage Oculomotor Cranial Nerve Palsy We propose that unilateral CNIII palsy is a possible sign of NASAH. Diagnostic angiograms were negative for aneurysms therefore, SAH were determined to be spontaneous. Unilateral CNIII palsy in the setting of NASAH was identified in both patients. Patients were managed with best medical therapy and followed up in the outpatient setting. ![]() Magnetic resonance imaging and angiograms for both patients were negative. ![]() Patients were admitted to the neuro intensive care unit and underwent diagnostic angiograms to identify possible aneurysms. A non-contrast head CT demonstrated a diffuse SAH predominantly in the Sylvian and suprasellar cisterns. Patient 2, 70-year-old male, presented with mild headache, acute onset of blurry vision, and right eye ptosis. A non-contrast head computed tomography (CT) demonstrated a SAH within the left sylvian fissure and blood surrounding the mesencephalon and falx. Patient 1, 52-year-old male, presented with headache, left eye ptosis, and painless diplopia. Two patients were admitted to a single institution for SAH. Thus, clinicians must be aware of the variable clinical presentations of this condition. Early diagnosis is paramount to determine treatment course. Subarachnoid hemorrhage (SAH) can present with various signs and symptoms. We present a case series of two patients who developed unilateral cranial nerve III (CNIII) palsy following non-aneurysmal SAH (NASAH). Queen Lane Philadelphia, PA 19129, USA Tel +1-91 E-m23 3 2022 24 3 267 275 24 6 2021 10 10 2021 29 10 2021 Copyright © 2022 by KSCVS and KoNES 2022 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. JCEN Journal of Cerebrovascular and Endovascular Neurosurgery J Cerebrovasc Endovasc Neurosurg 2234-8565 2287-3139 Korean Society of Cerebrovascular Surgeons and Korean NeuroEndovascular Society 10.7461/2021.06.007 jcen-2022-e7 Case Report Isolated oculomotor nerve palsy secondary to non-aneurysmal subarachnoid hemorrhage Mehta Shyle 1 Bathini Abhijith 1 Dubey Anwesha 2 Barpujari Awinita 1 Kassem Ahmad 2 Sulaiman Mohanad 3 Binning Mandy 3 1Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, PA, USA 2Department of Neurosurgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA 3Department of Neurosurgery, Global Neurosciences Institute, Chester, PA, USA Correspondence to Shyle Mehta Department of Neurosurgery, Drexel University College of Medicine 2900 W. Journal of Cerebrovascular and Endovascular Neurosurgery INTRODUCTION
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