An 81-year-old woman with recurrent episodes of sudden, painful, third nerve palsy with paralytic mydriasis and transient hypertension was found to have a vascular anomaly heretofore, to our knowledge, not described in the literature. Cerebral angiography revealed dilatation and tortuosity of the posterior cerebral artery. Third nerve compression by this ectatic vessel is the presumed cause of the ophthalmoplegia. Review of the literature failed to uncover previous recognition of this entity.
Hopkins EW, Poser CM. Posterior Cerebral Artery Ectasia: An Unusual Cause of Ophthalmoplegia. Arch Neurol. 1973;29(4):279–281. doi:10.1001/archneur.1973.00490280091015
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