Unilateral oculomotor nerve palsy caused by arterial compression accompanying subarachnoid hemorrhage: a case report

• Published in: Acta neurochirurgica Vol. 163; no. 3; pp. 813 - 816
• Main Authors: Saito, Shoji, Hasegawa, Hitoshi, Takino, Toru, Ando, Kazuhiro, Shibuya, Kohei, Takahashi, Haruhiko, On, Jotaro, Suzuki, Tomoaki, Oishi, Makoto, Fujii, Yukihiko
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.03.2021; Springer Nature B.V
• Subjects: Aneurysm; Aneurysms; Arteries; Case Report - Vascular Neurosurgery - Aneurysm; Case reports; Compression; Interventional Radiology; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Neurological disorders; Neurology; Neuroradiology; Neurosurgery; Oculomotor nerve; Paralysis; Subarachnoid hemorrhage; Surgical Orthopedics; Vascular Neurosurgery – Aneurysm; Veins & arteries; Internal carotid-posterior communicating artery aneurysm; Oculomotor nerve palsy; Subarachnoid hemorrhage; Posterior cerebral artery
• ISSN: 0001-6268; 0942-0940
• DOI: 10.1007/s00701-020-04633-x

Unilateral oculomotor nerve palsy, often caused by aneurysmal compression, is one of the decisive findings for confirming the site of a ruptured aneurysm. However, arterial compression can also cause unilateral oculomotor nerve palsy. Here, we present the case of a 59-year-old woman with a ruptured right internal carotid-posterior communicating artery aneurysm accompanied by contralateral oculomotor nerve palsy. The nerve was found to be compressed by the posterior cerebral artery and was isolated from the ruptured aneurysm. When confirming a ruptured aneurysm based on the evidence of unilateral oculomotor palsy, the arteries surrounding the nerve must be thoroughly assessed.