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J Neurol Surg Rep 2014; 75(01): e180-e182
DOI: 10.1055/s-0034-1378155
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Unruptured Internal Carotid-Posterior Communicating Artery Aneurysm Splitting the Oculomotor Nerve: A Case Report and Literature Review

Shingo Toyota
1   Department of Neurosurgery, Kansai Rosai Hospital, Hyogo, Japan
,
Takuyu Taki
1   Department of Neurosurgery, Kansai Rosai Hospital, Hyogo, Japan
,
Akatsuki Wakayama
2   Department of Neurosurgery, Osaka Neurological Institute, Osaka, Japan
,
Toshiki Yoshimine
3   Department of Neurosurgery, Osaka University Medical School, Osaka, Japan
› Author Affiliations
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Publication History

01 January 2014

22 April 2014

Publication Date:
04 June 2014 (online)

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Abstract

Objective To report a rare case of unruptured internal carotid-posterior communicating artery (IC-PC) aneurysm splitting the oculomotor nerve treated by clipping and to review the previously published cases.

Case Presentation A 42-year-old man suddenly presented with left oculomotor paresis. Three-dimensional digital subtraction angiography (3D DSA) demonstrated a left IC-PC aneurysm with a bulging part. During surgery, it was confirmed that the bulging part split the oculomotor nerve. After the fenestrated oculomotor nerve was dissected from the bulging part with a careful microsurgical technique, neck clipping was performed. After the operation, the symptoms of oculomotor nerve paresis disappeared within 2 weeks.

Conclusions We must keep in mind the possibility of an anomaly of the oculomotor nerve, including fenestration, and careful observation and manipulation should be performed to preserve the nerve function during surgery, even though it is very rare.

Keywords

fenestration - oculomotor nerve - internal carotid-posterior communicating artery aneurysm - three-dimensional digital subtraction angiography
 

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