Oculomotor Nerve Palsy in Association with a Ruptured Internal Carotid Artery Bifurcation Aneurysm: Case Report.
- Author:
Do Sung LEE
1
;
Sung Don KANG
;
Jong Moon KIM
Author Information
1. Department of Neurosurgery, School of Medicine, Wonkwang University, Iksan, Korea. kangsd@wonkwang.ac.kr
- Publication Type:Case Report
- Keywords:
Ophthalmoplegia;
Internal carotid artery bifurcation;
Aneurysm
- MeSH:
Aged;
Aneurysm*;
Angiography;
Carotid Artery, Internal*;
Follow-Up Studies;
Hemorrhage;
Humans;
Oculomotor Nerve Diseases*;
Oculomotor Nerve*;
Ophthalmoplegia;
Paralysis;
Pupil;
Stupor
- From:Korean Journal of Cerebrovascular Surgery
2005;7(3):238-240
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We report a rare case of third cranial nerve palsy due to a ruptured left internal carotid artery (ICA) bifurcation aneurysm. A 70-year-old man was stuporous with left ophthalmoplegia (unilaterally fixed dilated pupil, abducted eyes, and ptosis). A computed tomography demonstrated extensive hemorrhage spreading around the left sylvian fissure and basal cistern with a ipsilateral predominance, and intraventricular hemorrhage without focal mass effect. A computed tomographic angiography demonstrated a 3mm sized aneurysmal sac which arose from the left ICA bifurcation. The aneurysmal clipping was performed at 1 day after onset. In operative field, there was no direct compression of the oculomotor nerve by the aneurysmal fundus. Postoperatively, he recovered to alert mental status, but left ophthalmoplegia recovered partially at the 1 year follow-up.
