Third nerve paresis caused by vascular compression by the posterior communicating artery

Mulderink, Todd; Bendok, Bernard R.; Yapor, Wesley Y.; Batjer, H. Hunt

doi:10.1053/jscd.2001.25469

Cited by 16 publications

(7 citation statements)

References 15 publications

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“…More interestingly a high has been found. Dilatation of PCoA can compress the oculomotor nerve and paresis may occur [16]. Greatest diameter of right and left PCoA in present study is 3.8mm and 3.6mm respectively which is closely matched with the report of Pai (right PCoA=4mm) [9] and Kamath (left PCoA=3.5mm) [6].…”

Section: Discussionsupporting

confidence: 89%

A Cadaveric Study of Bilateral Configuration of Posterior Bifurcation of Posterior Communicating Artery in Indian Population

Saha

Sarkar

Mandal

2015

JCDR

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Section: Discussionsupporting

confidence: 89%

A Cadaveric Study of Bilateral Configuration of Posterior Bifurcation of Posterior Communicating Artery in Indian Population

Saha

Sarkar

Mandal

2015

JCDR

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“…These cases showed prompt recovery of oculomotor nerve palsy similar to ours. On the other hand, oculomotor nerve palsy due to direct aneurysm compression or stroke recovers very slowly after repair of the aneurysm (13). Therefore, the clinical course of the present case also supports the idea that oculomotor nerve palsy may be caused by the jet flow of bleeding.…”

Section: Discussionsupporting

confidence: 81%

Oculomotor Nerve Palsy in a Patient with a Ruptured Middle Cerebral Artery Aneurysm

et al. 2017

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: We describe a case of acute oculomotor nerve palsy caused by a ruptured middle cerebral artery (MCA) aneurysm. A 59-year-old female presenting with headache and nausea was admitted to our hospital. Her consciousness was alert, and had no other neurological deficit without left oculomotor nerve palsy. A computed tomography (CT) showed SAH extending from left sylvian cistern to basal cistern. CT angiography revealed a left MCA aneurysm which protruded toward internal carotid artery. The patient was successfully treated with surgical clipping. The oculomotor nerve palsy resolved immediately after the surgery. Perioperative radiological evaluation revealed that there were no evidence of midbrain hemorrhage or stroke, vessel anomaly of basilar, posterior cerebral or superior cerebellar artery, vasospasm, and uncal herniation. Furthermore, intraoperative findings revealed that the aneurysm was projected toward the affected carotid cistern and oculomotor nerve. From these findings and time course of oculomotor nerve palsy, it is suggested that the jet flow of bleeding from the ruptured MCA aneurysm caused oculomotor nerve palsy in the patient.

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“…It is well known that cerebral arteriosclerosis is a predisposing factor that can lead to ONP. The medical community also agrees that the severity of arteriosclerosis increases with age, which is an irreversible condition[ 25 ]. Therefore, surgical intervention is ultimately needed to solve this issue.…”

Section: Discussionmentioning

confidence: 99%

Microvascular decompression for a patient with oculomotor palsy caused by posterior cerebral artery compression: A case report and literature review

Zhang¹,

Wei²,

Wang³

et al. 2022

WJCC

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BACKGROUND Aneurysm compression, diabetes, and traumatic brain injury are well-known causative factors of oculomotor nerve palsy (ONP), while cases of ONP induced by neurovascular conflicts have rarely been reported in the medical community. Here, we report a typical case of ONP caused by right posterior cerebral artery (PCA) compression to increase neurosurgeons’ awareness of the disease and reduce misdiagnosis and recurrence. CASE SUMMARY A 54-year-old man without a known medical history presented with right ONP for the past 5 years. The patient presented to the hospital with right ptosis, diplopia, anisocoria (rt 5 mm, lt 2.5 mm), loss of duction in all directions, abduction, and light impaired pupillary reflexes. Magnetic resonance angiography and computed tomography venography examinations showed no phlebangioma, aneurysm, or intracranial lesion. After conducting oral glucose tolerance and prostigmin tests, diabetes and myasthenia gravis were excluded. Cranial nerve magnetic resonance imaging showed that the right PCA loop was in direct contact with the cisternal segment of the right oculomotor nerve (ON). Microvascular decompression (MVD) of the culprit vessel from the ON through a right subtemporal craniotomy was carried out, and the ONP symptoms were significantly relieved after 3 mo. CONCLUSION Vascular compression of the ON is a rare pathogeny of ONP that may be refractory to drug therapy and ophthalmic strabismus surgery. MVD is an effective treatment for ONP induced by neurovascular compression.

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Third nerve paresis caused by vascular compression by the posterior communicating artery

Cited by 16 publications

References 15 publications

A Cadaveric Study of Bilateral Configuration of Posterior Bifurcation of Posterior Communicating Artery in Indian Population

A Cadaveric Study of Bilateral Configuration of Posterior Bifurcation of Posterior Communicating Artery in Indian Population

Oculomotor Nerve Palsy in a Patient with a Ruptured Middle Cerebral Artery Aneurysm

Microvascular decompression for a patient with oculomotor palsy caused by posterior cerebral artery compression: A case report and literature review

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