Upper basilar artery aneurysms: oculomotor outcomes in 163 cases

2005 ◽  
Vol 102 (3) ◽  
pp. 482-488 ◽  
Author(s):  
Hisham Al-Khayat ◽  
Haitham Al-Khayat ◽  
Jonathan White ◽  
David Manner ◽  
Duke Samson
Keyword(s):  
Basilar Artery ◽  
Nerve Palsy ◽  
Arterial Occlusion ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Stepwise Logistic Regression ◽  
Categorical Data Analysis ◽  
Content Type ◽  
History Of ◽  
Fine Print

Object. The purpose of this study was to identify factors predictive of postoperative oculomotor nerve palsy among patients who undergo surgery for distal basilar artery (BA) aneurysms. The data can be used to estimate preoperative risk in this population. The natural history of oculomotor nerve palsy in patients with good outcomes is also defined. Methods. The cases of 163 patients with distal BA aneurysms, who were treated surgically between 1996 and 2002, were retrospectively studied to identify factors contributing to oculomotor nerve palsy. After the data had been collected, stepwise logistic regression procedures were used to determine the predictive effects of each variable on the development of oculomotor nerve palsy and to create a scoring system. Factors that interfered with resolution of oculomotor dysfunction in patients with good outcomes were also studied. Postoperative oculomotor nerve palsy occurred in 86 patients (52.8%) with distal BA aneurysms. The following factors were associated with postoperative oculomotor dysfunction, as determined by a categorical data analysis: 1) younger patient age (p < 0.001); 2) poor admission Hunt and Hess grade (p < 0.001); 3) use of temporary arterial occlusion (p < 0.001); 4) poor Glasgow Outcome Scale score (p < 0.001); and 5) the presence of a BA apex aneurysm that projected posteriorly (p < 0.001). For patients with good outcomes, postoperative oculomotor nerve palsy resolved completely within 3 months in 31 patients (52%) and within 6 months in 47 patients (80%). The projection of the BA aneurysm was associated with incomplete oculomotor recovery at 6 months postoperatively (p = 0.019). Conclusions. The results of this study can help identify patients with a high risk for the development of oculomotor nerve palsy. This may help neurosurgeons in preoperative planning and discussions.

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.

Papillary meningioma involving the oculomotor nerve in an infant

1986 ◽  
Vol 64 (5) ◽  
pp. 808-812 ◽  
Author(s):  
Joseph H. Piatt ◽  
Gerald A. Campbell ◽  
W. Jerry Oakes
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Clinical Implications ◽  
Content Type ◽  
Papillary Meningioma ◽  
Histological Variant ◽  
Fine Print

✓ A 6-month-old child with an isolated oculomotor nerve palsy was found to have a papillary meningioma infiltrating the nerve along its intracranial course adjacent to the midbrain. The clinical implications of this unusual histological variant are discussed.

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.

scholarly journals Case of Periodic Oculomotor Nerve Palsy

2020 ◽  
Vol V (1) ◽  
pp. 107-114
Author(s):  
G. A. Klyachkin
Keyword(s):  
Nerve Palsy ◽  
Russian Literature ◽  
Periodic Paralysis ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Foreign Literature ◽  
History Of

Periodically recurring paralysis of the oculomotor nerve (migraine ophthalmoplegique French authors) is not often observed. In foreign literature, I managed to collect 24 cases, and in Russian literature, as far as I know, there is only one observation by prof. L.O.Darkshevich. In view of this, I think it is interesting to give a brief history of the illness of one patient, in whom, during the last day, I observed periodic paralysis of the oculomotor nerve

Malignant meningioma of the oculomotor nerve without dural attachment

1998 ◽  
Vol 88 (6) ◽  
pp. 1104-1106 ◽  
Author(s):  
Alister J. Hart ◽  
James Allibone ◽  
Adrian T. H. Casey ◽  
David G. T. Thomas
Keyword(s):  
Spindle Cell ◽  
Oculomotor Nerve ◽  
Histological Investigation ◽  
Malignant Meningioma ◽  
Resonance Imaging ◽  
Content Type ◽  
Spindle Cell Lesion ◽  
History Of ◽  
Dural Attachment ◽  
Fine Print

✓ Meningiomas, thought to arise from arachnoid cap cells, are usually attached to the dura. Malignancy is present in approximately 1% of these tumors. The authors report the case of a patient with a malignant meningioma arising from the oculomotor nerve with no dural attachment. The patient presented with a 7-month history of left-sided ptosis and diplopia. Magnetic resonance imaging demonstrated an extrinsic mass compressing the root of the oculomotor nerve at its exit from the midbrain. During surgery, a left-sided subtemporal approach revealed the tumor to be arising from the oculomotor nerve. Histological investigation showed a malignant spindle cell lesion with an immunohistochemical profile that was consistent with malignant meningioma. To the authors' knowledge, this is the first documented case of a malignant meningioma arising from the oculomotor nerve.

Bilateral oculomotor nerve palsy due to dolichoectasia of the basilar artery

1997 ◽  
Vol 17 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Carsten Moschner ◽  
Andreas Moser ◽  
Detlef Kömpf
Keyword(s):  
Basilar Artery ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy

A comparison between endovascular and surgical management of basilar artery apex aneurysms

1999 ◽  
Vol 90 (5) ◽  
pp. 868-874 ◽  
Author(s):  
David P. Gruber ◽  
Gary A. Zimmerman ◽  
Thomas A. Tomsick ◽  
Harry R. van Loveren ◽  
Michael J. Link ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Surgical Management ◽  
Basilar Artery ◽  
Acute Stage ◽  
Content Type ◽  
Long Term Follow Up ◽  
Detachable Coils ◽  
History Of ◽  
Surgical Group ◽  
Fine Print

Object. The goal of this retrospective study was to evaluate endovascular treatment by means of Guglielmi detachable coils (GDCs) compared with surgical management for basilar artery (BA) apex aneurysms.Methods. Forty-one patients presented with saccular BA apex aneurysms with angiographically definable necks that were judged suitable for either treatment. Of 20 patients who underwent surgery and 21 who underwent GDC embolization, 15 (75%) and 11 (52%), respectively, were treated in the acute phase after subarachnoid hemorrhage (SAH). Twenty-four (92%) of the 26 patients presenting with an SAH had a Hunt and Hess Grade III or better. Fifteen patients with unruptured or ruptured aneurysms more than 14 days post-SAH were treated electively. Patients in the endovascular and surgical treatment groups had aneurysms with comparable dimensions and configurations. Overall, 15 (75%) of the surgical patients and 20 (95%) of the patients in whom GDC embolization was performed had a good outcome (Glasgow Outcome Scale score of 4 or 5). Among those patients treated in the acute stage post-SAH, 11 (73%) of the surgical group and 10 (91%) of the endovascular group did well. Fourteen patients treated electively (93%) had good outcomes. There were two deaths (10%) in the surgical group and none in the endovascular group. Patients treated surgically were hospitalized twice as long and incurred twice the expenses of patients who underwent endovascular treatment (p < 0.001).Conclusions. Endovascular GDC embolization of select BA apex aneurysms may be a competitive alternative to direct surgical clipping. Long-term follow up is needed to better define the natural history of the endovascularly treated aneurysm and to further evaluate the accuracy of these preliminary results.

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