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A 23 year-old man developed the abrupt onset an explosive headache followed by nausea and vomiting. On exam, he had a right third nerve palsy.
Cerebral angiogram, right internal artery injection. Note the aneurysm arising from the posterior communicating artery. This is one of the common locations for aneurysms. The proximity of the posterior communicating artery to the third nerve may result in a third nerve palsy from mass effect from the adjacent aneurysm.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.