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Case Study 195: Brain Aneurysm - PCOM A posterior communicating artery (PCOM) aneurysm is one of the most common causes of a cranial nerve III palsy - that’s the nerve that moves most of the eye muscles, controls the eyelid, and constricts the pupil. When compressed by an aneurysm, patients can present with: 👁 Droopy eyelid (ptosis) 👁 Eye deviation “down and out” 👁 Dilated pupil - this is a key red flag! 💡 Did you know? 🔹 About 2-5% of the population have a brain aneurysm, but most never rupture. 🔹 PCOM aneurysms account for 15-25% of intracranial aneurysms. 🔹 A painful CN III palsy with pupil involvement is considered an aneurysm until proven otherwise - this is a neurosurgical emergency! Treatment options include microsurgical clipping or endovascular coiling to secure the aneurysm and prevent rupture. 🔬 Early recognition and prompt imaging (CTA or MRA) can be life-saving - always take new double vision, droopy eyelid, or sudden pupil changes seriously! September is Aneurysm Awareness Month - a time to spread knowledge, support research, and encourage early detection. Share this to raise awareness and possibly save a life. #Neurosurgery #CranialNerveIII #BrainAneurysm #AneurysmAwareness #CaseStudy195 #LadySpineDoc #SundayCaseStudy