An 80-year-old woman presented to the hospital with a 7-day history of diplopia.
The diagnosis was complete third cranial nerve palsy with pupillary involvement.
He did not report headache, mandibular claudication or neck rigidity.
Her personal history was only significant for hypertension.
His antecedents were uninterested.
Examination of ocular motility in the left eye (LE) was normal.
The right eye (OD) had ptosis cerebrial and limitation of mobility in all positions except in appearance.
The pupillary reaction to light in the left eye was 3 mm to 2 mm, pupillary response in the right eye was slow from 5 mm to 4 mm. There was no afferent pupillary defect.
Examination with a cleft palate was characteristic of bilateral cataract.
The eye fundus was normal.
Brain magnetic resonance angiography did not detect any pathology.
In the laboratory study the erythrocyte sedimentation rate (GSR) was 28 mm/h, C-reactive protein 0.2 mg/dl (normal, <0.8 mg/dl000) and platelets 175.
Rheumatoid factor, antinuclear antibodies, antineutrophil cytoplasmic antibodies, anti-acetylcholine receptor antibodies, and serology were negative.
The diagnosis of TA was considered and a biopsy of the temporal artery was performed.
Pathology revealed stenosis of the arterial lumen with rupture of the internal limiting factor and inflammatory and giant cells.
