Ruptured Anterior Communicating Artery Aneurysm Causing Bilateral Oculomotor Nerve Palsy: A Case Report.
10.3346/jkms.2007.22.1.173
- Author:
Sung Don KANG
1
Author Information
1. Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea. kangsd@wonkwang.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Oculomotor Nerve;
Paralysis;
Palsy;
Anterior Communicating Artery;
Intracranial Aneurysm
- MeSH:
Rupture, Spontaneous;
Oculomotor Nerve Diseases/*etiology;
Magnetic Resonance Imaging;
Intracranial Aneurysm/*complications/surgery;
Humans;
Female;
Aged
- From:Journal of Korean Medical Science
2007;22(1):173-176
- CountryRepublic of Korea
- Language:English
-
Abstract:
A rare case of bilateral third cranial nerve palsy due to a ruptured anterior communicating artery aneurysm is presented. A 68-yr-old woman was semicomatose with bilaterally fixed dilated pupil, abducted eyes, and ptosis. A computed tomography demonstrated extensive hemorrhage spreading around the both Sylvian and interhemisheric fissure without focal mass effect. Intracranial pressure via extraventricular drainage before surgery was 15-50 mmHg. Three months later, brain MRI showed infarction of left posterior cerebral artery territory and lacuna infarction of the pons. Eleven months after aneurysm repair, nerve palsy improved slowly and recovered partially. The patient communicated well with simple words. The author reviewed and discussed the possible mechanism of this rare neuro-ophthalmological manifestation in view of a false localizing sign.
