We report an unusual case of a 54-year-old man with third nerve palsy caused by an extra-axial cavernoma in relation to the cisternal portion of the oculomotor nerve. In addition to this lesion, the patient had multiple intracranial cavernomas. Interestingly, an initial MRI without T2* gradient sequence missed the multiple cavernomas. A subsequent MRI done after one month showed an increase in size with fluid level within the extra-axial cavernoma.
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