Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH
An unusual case of anisocoria in a child with bleeding aneurysm of posterior communicating artery and idiopathic thrombocytopenic purpura (ITP).
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BACKGROUND
ITP can give rise to bleeding episodes in different parts of the body including the central nervous system with various systemic manifestations.
METHODS
An eight-year old female child, diagnosed as a case of chronic ITP for last two years, developed intense headache and vomiting for a few days before admission. This was associated with right sided mid dilated pupil with brisk reaction to light. MRI-angiography showed a bleeding aneurysm of posterior communicating artery. The features of raised intra cranial tension subsided with conservative management but the anisocoria persisted.
CONCLUSIONS
A bleeding aneurysm can manifest with anisocoria as a sign of partial third cranial nerve palsy.
