scholarly journals Early Endovascular Management of Oculomotor Nerve Palsy Associated with Posterior Communicating Artery Aneurysms

2010 ◽  
Vol 16 (1) ◽  
pp. 17-21 ◽  
Author(s):  
A. Santillan ◽  
W.E. Zink ◽  
J. Knopman ◽  
H.A. Riina ◽  
Y.P. Gobin
Keyword(s):  
Nerve Palsy ◽  
Clinical Presentation ◽  
Endovascular Embolization ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Endovascular Management ◽  
Third Nerve Palsy ◽  
The Third ◽  
Third Nerve

Palsy of the third cranial nerve (oculomotor nerve, CNIII) is a well-known clinical presentation of posterior communicating artery (P-com) aneurysm. We report a series of 11 patients with partial or complete third nerve palsy secondary to P-com aneurysm. All were treated with endovascular embolization within seven days of symptom onset. Third nerve palsy symptoms resolved in 7/11 (64%), improved in 2/11 (18%) and did not change in 2/11 (18%) patients

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V19
Author(s):  
Hussam Abou-Al-Shaar ◽  
Timothy G. White ◽  
Ivo Peto ◽  
Amir R. Dehdashti
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Entry Zone ◽  
Third Nerve Palsy ◽  
History Of ◽  
Tectal Plate ◽  
The Right ◽  
Transtentorial Approach ◽  
Third Nerve

A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.The video can be found here: https://youtu.be/ofj8zFWNUGU.

Functional anatomy of headache: circle of Willis aneurysms, third cranial nerve and pain

2011 ◽  
pp. 82-88
Author(s):  
Marcelo Moraes Valença ◽  
Luciana P. A. Andrade-Valença ◽  
Carolina Martins
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Functional Anatomy ◽  
Circle Of Willis ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Microsurgical Anatomy ◽  
Third Nerve Palsy ◽  
The Right ◽  
Third Nerve

Patients with intracranial aneurysm located at the internal carotid artery-posterior communicating artery (ICA-PComA) often present pain on the orbit or fronto-temporal region ipsilateral to the aneurysm, as a warning sign a few days before rupture. Given the close proximity between ICA-PComA aneurysm and the oculomotor nerve, palsy of this cranial nerve may occurduring aneurysmal expansion (or rupture), resulting in progressive eyelid ptosis, dilatation of the pupil and double vision. In addition, aneurysm expansion may cause compression not only of the oculomotor nerve, but of other skull base pain-sensitive structures (e.g. dura-mater and vessels), and pain ipsilateral to the aneurysm formation is predictable. We reviewed the functional anatomy of circle of Willis, oculomotor nerve and its topographical relationships in order to better understand the pathophysiology linked to pain and third-nerve palsy caused by an expanding ICAPComA aneurysm. Silicone-injected, formalin fixed cadaveric heads were dissected to present the microsurgical anatomy of the oculomotor nerve and its topographical relationships. In addition, the relationship between the right ICA-PComA aneurysm and the right third-nerve is also shown using intraoperative images, obtained during surgical microdissection and clipping of an unruptured aneurysm. We also discuss about when and how to investigate patients with headache associated with an isolated third-nerve palsy.

Aberrant regeneration in idiopathic oculomotor nerve palsy

1980 ◽  
Vol 52 (6) ◽  
pp. 854-856 ◽  
Author(s):  
Jose F. Laguna ◽  
Michael S. Smith
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Aberrant Regeneration ◽  
Oculomotor Function ◽  
Third Nerve ◽  
Fine Print

✓ Aberrant regeneration of the oculomotor nerve usually follows injury to the nerve by posterior communicating artery aneurysms or trauma. A case of idiopathic third nerve palsy with pupillary involvement occurred in an otherwise healthy 38-year-old man. Follow-up examination 32 months later showed evidence of oculomotor function with aberrant regeneration.

A Retrospective Comparison of the Influence of Surgical Clipping and Endovascular Embolization on Recovery of Oculomotor Nerve Palsy in Patients With Posterior Communicating Artery Aneurysms

Neurosurgery ◽  
2015 ◽  
Vol 76 (6) ◽  
pp. 687-694 ◽  
Author(s):  
Haibin Tan ◽  
Guangfu Huang ◽  
Tian Zhang ◽  
Jinping Liu ◽  
Zhili Li ◽  
...  
Keyword(s):  
Recovery Time ◽  
Nerve Palsy ◽  
Postoperative Recovery ◽  
Endovascular Embolization ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Common Symptom ◽  
Surgical Clipping ◽  
The Impact

Abstract BACKGROUND: Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysms (PcomAAs). Surgical clipping and endovascular embolization are used to treat PcomAAs with ONP. OBJECTIVE: To analyze the impact of these 2 techniques on recovery of ONP caused by PcomAAs. METHODS: The clinical data for 176 patients with intracranial PcomAAs with ONP admitted to the Department of Neurosurgery, Sichuan Provincial People's Hospital, between June 2008 and May 2013 who undergone surgical clipping or endovascular embolization were studied retrospectively. The 2 treatment groups were compared with respect to age, sex, aneurysm size, levels of hypertension and hyperlipidemia, preadmission ONP duration, subarachnoid hemorrhage (SAH), complete ONP, postoperative recovery time from ONP symptoms, and degree of recovery. The follow-up duration was a minimum of 12 months. Multivariate Cox regression was used for analysis. RESULTS: A total of 132 patients were treated by surgical clipping, and 44 were treated by endovascular embolization. Significant differences were found in postoperative recovery time (83.87 ± 34.70 days for clipping and 137.45 ± 44.94 days for embolization, P < .001) and recovery rates (130 [98.5%] for clipping and 30 [68.2%] for embolization, P < .001). The period between ONP onset and admission was associated with recovery. Postoperative complications included significant cerebral vasospasms (6 in the clipping group and 2 in the embolization group) and hydrocephalus (16 in the clipping group and 9 in the embolization group). CONCLUSION: Simultaneous elimination of 2 injury mechanisms, compression and pulsation, when treating the oculomotor nerve by surgical clipping may be more advantageous than endovascular embolization to treat ONP caused by PcomAA.

scholarly journals Recovery of posterior communicating artery aneurysm induced oculomotor nerve palsy: a comparison between surgical clipping and endovascular embolization

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Li-qiang Tian ◽  
Qing-xi Fu
Keyword(s):  
Nerve Palsy ◽  
Artery Aneurysm ◽  
Endovascular Embolization ◽  
Aneurysm Rupture ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Common Symptom ◽  
Surgical Clipping ◽  
Posterior Communicating Artery Aneurysm

Abstract Background Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysm (PcomAA) that can lead to impaired eye movement and pupil dilation. Currently, surgical clipping and endovascular embolization are the two most popular treatment methods for PcomAA-induced ONP; however, the recovery outcome between the two methods remains to be elucidated. Methods In the present study, we thoroughly compared the pretreatment factors and recovery outcome of the two treatments on 70 patients with PcomAA-induced ONP. The patients were separated into two groups based on the treatment that was received. Pretreatment factors, including age, sex, time period between ONP onset and treatment, ONP type, aneurysm diameter, status of subarachnoid hemorrhage and aneurysm rupture were recorded for each individual patient. Recovery outcome of the patients was assessed over a 12-month period. Results No significant differences were observed in any of the analyzed factors. Importantly, we revealed a significantly higher full recovery rate for the patients receiving the surgical clipping treatment than the ones that received the endovascular embolization treatment. In addition, we showed that patients’ age was negatively correlated with the recovery extent in both treatment groups. Conclusions The outcome of our study suggests that surgical clipping might be a better option to treat PcomAA-induced ONP.

scholarly journals Multiple Sclerosis Presenting as Isolated Oculomotor Nerve Palsy

1986 ◽  
Vol 13 (3) ◽  
pp. 270-272 ◽  
Author(s):  
Ryan J. Uitti ◽  
A.H. Rajput
Keyword(s):  
Multiple Sclerosis ◽  
Emergency Room ◽  
Nerve Palsy ◽  
Rapid Onset ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Nerve Paralysis ◽  
Pupillary Dilatation ◽  
The Third ◽  
Third Nerve

ABSTRACT:A 23-year old woman came to the emergency room with an isolated oculomotor nerve palsy (including pupillary dilatation) of rapid onset. Investigations and history revealed no cause. The subsequent course of events indicated a diagnosis of multiple sclerosis. While the third nerve has been shown to be involved during the course of multiple sclerosis, this is the first report of a case presenting as an isolated oculomotor nerve paralysis.

Sign in / Sign up

Export Citation Format

Share Document