The Telltale Botox: Botulinum Toxin Injection by an Expert Hand as an Intracranial Aneurysm Detector

Giorgio Caddia, MD; Giulio J. Jaber, MD; Francesca Granata, MD, PhD; Karol Galletta, MD; Antonio Pitrone, MD; Paolino La Spina, MD; Ferdinando Stagno d’Alcontres, MD; Francesco Stagno d’Alcontres, MD, PhD

doi:10.1097/GOX.0000000000005452

Plastic and Reconstructive Surgery, Global Open (Dec 2023)

The Telltale Botox: Botulinum Toxin Injection by an Expert Hand as an Intracranial Aneurysm Detector

Giorgio Caddia, MD,
Giulio J. Jaber, MD,
Francesca Granata, MD, PhD,
Karol Galletta, MD,
Antonio Pitrone, MD,
Paolino La Spina, MD,
Ferdinando Stagno d’Alcontres, MD,
Francesco Stagno d’Alcontres, MD, PhD

Affiliations

Giorgio Caddia, MD: From the * Plastic, Reconstructive and Aesthetic Surgery Unit, Department of Human Pathology, University of Messina, Messina, Italy
Giulio J. Jaber, MD: From the * Plastic, Reconstructive and Aesthetic Surgery Unit, Department of Human Pathology, University of Messina, Messina, Italy
Francesca Granata, MD, PhD: † Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
Karol Galletta, MD: † Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
Antonio Pitrone, MD: † Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
Paolino La Spina, MD: ‡ Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Ferdinando Stagno d’Alcontres, MD: § Otorhinolaryngology Unit, Papardo Hospital, Messina, Italy.
Francesco Stagno d’Alcontres, MD, PhD: From the * Plastic, Reconstructive and Aesthetic Surgery Unit, Department of Human Pathology, University of Messina, Messina, Italy

DOI: https://doi.org/10.1097/GOX.0000000000005452
Journal volume & issue: Vol. 11, no. 12
p. e5452

Abstract

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Summary:. Complications in aesthetic medicine can be considered a consequence of the inexperience of the performing physician, but in some cases, they can unveil far more serious conditions, hitherto silent. We present a case of a 48-year-old patient who, following botulinum toxin type A (Botox) injection for treatment of forehead wrinkles, returned to our attention 12 days later for a discrete, newly onset right eyelid ptosis. This ptosis was a telltale sign of the presence of an intracranial aneurysm closely related with the oculomotor nerve. The lack of compensatory action by the frontalis muscle in maintaining the eyelid in position allowed us to highlight the extrinsic compression deficit of the oculomotor nerve. Subsequently, the patient underwent endovascular treatment of the aneurysm, leading to complete resolution of the case.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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