scholarly journals Unruptured internal carotid–posterior communicating artery aneurysm splitting the oculomotor nerve: Case report

Nosotchu ◽  
2010 ◽  
Vol 32 (2) ◽  
pp. 163-166 ◽  
Author(s):  
Hidetsugu Maekawa ◽  
Hiromu Hadeishi ◽  
Michihiro Tanaka
Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 650-653 ◽  
Author(s):  
Tadashi Kudo

Abstract Intraoperative oculomotor nerve injury in a patient with a true posterior communicating artery aneurysm is reported in detail. A comparison of internal carotid artery aneurysms at the posterior communicating artery junction with true posterior communicating artery aneurysms deserves special attention, because the vascular relationships of the aneurysm are more complex. A clip along the internal carotid artery does not occlude blood flow to the aneurysm, and the aneurysmal neck and the distal posterior communicating artery are closer to the oculomotor nerve. This is the 27th reported case of a true posterior communicating artery aneurysm. The incidence of true posterior communicating artery aneurysms ranges from 0.1 to 2.8% of all aneurysm patients. Such aneurysms constitute 4.6 and 11% of so-called posterior communicating aneurysms in two series. Difficulty associated with a preoperative diagnosis has been documented in at least 4 cases. An awareness of this rare aneurysm is stressed in order to avoid operative complications.


2020 ◽  
Vol 11 ◽  
pp. 353
Author(s):  
Hirotaka Inoue ◽  
Akihito Hashiguchi ◽  
Koichi Moroki ◽  
Hajime Tokuda

Background: Although it is well known that internal carotid-posterior communicating artery (ICA-PcomA) aneurysms compress the oculomotor nerve and cause nerve palsy, cases of ICA-PcomA aneurysms splitting the oculomotor nerve are extremely rare. Case Description: We present the rare case of an asymptomatic, growing, left-sided ICA-PcomA aneurysm that was confirmed to split the oculomotor nerve. We report the clinical course and discuss the underlying mechanism. The oculomotor nerve, which is an aggregate of multiple fibers, exhibits age-related loss of compactness in the arrangement of its nerve fibers. Conclusion: We speculate that injury to the nerve fibers by aneurysmal compression was avoided because of the rare phenomenon of splitting of the oculomotor nerve.


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