Abstract
Background and Importance We describe a patient who developed complete right oculomotor nerve palsy after endovascular
coiling for a ruptured posterior communicating artery aneurysm caused by migration
of the coils outside the aneurysm.
Clinical presentation A 50-year-old woman was admitted with an acute subarachnoid hemorrhage. She underwent,
on the day of admission, endovascular coiling of a ruptured posterior communicating
artery aneurysm. Four hours postcoiling, complete right oculomotor nerve palsy developed
because of extrusion of the coils outside the aneurysm. The patient recovered completely
after surgical exploration with removal of the migrated coils and microsurgical repair
of the oculomotor nerve.
Conclusion This report illustrates that oculomotor nerve palsy is a rare complication after
coiling of a posterior communicating artery aneurysm, and it should serve as a reminder
to encourage neurovascular teams to consider surgical exploration in cases of third
nerve palsy after endovascular coiling.
Keywords
aneurysm surgery - endovascular coiling - perforation - oculomotor nerve - microsurgical
repair - complication
