Paresis of the Oculomotor nerve due to neurovascular conflict with Superior Cerebellar Artery.
Journal
Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767
Informations de publication
Date de publication:
19 Sep 2024
19 Sep 2024
Historique:
medline:
20
9
2024
pubmed:
20
9
2024
entrez:
19
9
2024
Statut:
aheadofprint
Résumé
Neurovascular conflict between the Oculomotor nerve (CN III) and any of the posterior circulation cerebral arteries is a relatively frequent radiological finding, however, it does not manifest clinically or manifests itself only minimally (slowly reacts to light on the ipsilateral side). Sustained paresis of CN III arose directly due to neurovascular conflict between the Superior Cerebral Artery (SCA) and CN III, resolved after microvascular decompression, is extremely rare and has not yet been published. This case report aims to present a case of a scarce clinical condition caused by a generally common anatomical variation. This variation was proved to be the only cause of the clinical status and the symptoms did resolve after microsurgical restoration of the neuroanatomy. A 34-year-old female patient presented with an advancing ptosis and a downward gaze on one side. Differential diagnostics ruled out all other causes of the Oculomotor paresis, MRI showed significant oppression of the Oculomotor nerve by an aberrant SCA on the ipsilateral side. Neurovascular decompression performed microsurgically has resulted in near complete resolution of the symptoms. Oculomotor nerve paresis caused directly by neurovascular conflict is an extremely rare diagnosis, but microvascular decompression should be considered in these cases, especially if other reasons have been excluded.
Sections du résumé
BACKGROUND
BACKGROUND
Neurovascular conflict between the Oculomotor nerve (CN III) and any of the posterior circulation cerebral arteries is a relatively frequent radiological finding, however, it does not manifest clinically or manifests itself only minimally (slowly reacts to light on the ipsilateral side). Sustained paresis of CN III arose directly due to neurovascular conflict between the Superior Cerebral Artery (SCA) and CN III, resolved after microvascular decompression, is extremely rare and has not yet been published.
AIM
OBJECTIVE
This case report aims to present a case of a scarce clinical condition caused by a generally common anatomical variation. This variation was proved to be the only cause of the clinical status and the symptoms did resolve after microsurgical restoration of the neuroanatomy.
CASE DESCRIPTION
METHODS
A 34-year-old female patient presented with an advancing ptosis and a downward gaze on one side. Differential diagnostics ruled out all other causes of the Oculomotor paresis, MRI showed significant oppression of the Oculomotor nerve by an aberrant SCA on the ipsilateral side. Neurovascular decompression performed microsurgically has resulted in near complete resolution of the symptoms.
CONCLUSIONS
CONCLUSIONS
Oculomotor nerve paresis caused directly by neurovascular conflict is an extremely rare diagnosis, but microvascular decompression should be considered in these cases, especially if other reasons have been excluded.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.