The emerging role of magnetic reonance angiography in the management of patient with third cranial nerve paly Original Reearch Article

PURPOE: To dicu the enitivity of three-dimenional time-of-flight (3D TOF) magnetic reonance angiography (MRA) for detecting aneurym cauing third cranial nerve paly and to propoe guideline for the ue of MRA in the evaluation of patient with different clinical preentation of oculomotor nerve paly. METHOD: From a review of the cientific literature, we determined the proportion of aneurym of variou ize that caue third nerve paly, the enitivity of MRA in detecting aneurym of thee ize clae, and the relationhip of aneurymal ize to rupture. REULT: The data dicloe that properly performed and interpreted 3D TOF MRA will overlook only 1.5% of aneurym producing third cranial nerve paly that will, if untreated, rupture during the ubequent 8 year. CONCLUION: Magnetic reonance angiography play an important diagnotic role in the evaluation of patient with iolated third cranial nerve paly. However, becaue of the potentially dratic conequence of overlooking an aneurym, MRA hould be the definitive creening tet only among patient with a relatively low likelihood of harboring an aneurym or a relatively high likelihood of uffering a complication from catheter angiography.