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{
    "pk": 9715,
    "title": "Large Posterior Communicating Artery Aneurysm:  Initial Presentation with Reproducible Facial Pain Without Cranial Nerve Deficit",
    "subtitle": null,
    "abstract": "Abstract\nUnruptured posterior communicating artery (PCOM) aneurysms can be difficult to diagnose, and when large (≥ 7mm), represent a substantial risk to the patient. While most unruptured PCOM aneurysms are asymptomatic, when symptoms do occur, clinical manifestations typically include severe headache (HA), visual acuity loss, and cranial nerve deficit. This case report describes an atypical initial presentation of a large unruptured PCOM aneurysm with symptoms mimicking trigeminal neuralgia, without other associated cranial nerve palsies or neurologic deficits. The patient returned to the Emergency Department (ED) four days later with a HA and a cranial nerve VIII palsy.  After appropriate imaging, she was found to have a large PCOM aneurysm which was treated with surgical clipping with significant improvement in patient’s symptoms.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Posterior communicating aneurysm, trigeminal neuralgia, PCOM, facial pain"
        }
    ],
    "section": "Diagnostic Acumen",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/92t13044",
    "frozenauthors": [
        {
            "first_name": "Stacie",
            "middle_name": "",
            "last_name": "Zelman",
            "name_suffix": "",
            "institution": "Wake Forest University Baptist Health",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "C",
            "last_name": "Goebel",
            "name_suffix": "",
            "institution": "Wake Forest University Baptist health",
            "department": "None"
        },
        {
            "first_name": "Seth",
            "middle_name": "C",
            "last_name": "Hawkins",
            "name_suffix": "",
            "institution": "Wake Forest University Baptist Health",
            "department": "None"
        }
    ],
    "date_submitted": "2016-03-24T15:25:28Z",
    "date_accepted": "2016-03-24T15:25:28Z",
    "date_published": "2016-09-29T22:59:53Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/9715/galley/5382/download/"
        }
    ]
}