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Fig 2. A 52-year-old man presenting with acute ipsilateral ophthalmoplegia and contralateral CN III palsy with intact vision. A and B, Contrast-enhanced MR imaging (A) and angiography (B) shows giant left carotid hypophyseal aneurysm with intraluminal thrombus. Angiographic test occlusion was not tolerated. C, Angiogram 2 days after B shows enlargement of the aneurysmal lumen due to resolution of thrombus. D, Complete occlusion after stent-assisted coiling. One year later, right ophthalmoplegia was resolved. Residual upper gaze diplopia and 1- to 2-mm residual ptosis on the left side.
