19 May 2024
: Case report
Oculomotor Nerve Palsy Induced by a Cerebral Developmental Venous Anomaly: A Case Report and Comprehensive Review
Unknown etiology, Challenging differential diagnosis, Unusual or unexpected effect of treatment
Jianying Zhang12ABEF, Sisi Wang1EF, Ying Jiang3BE, Yue Zhang2ABE*DOI: 10.12659/AJCR.943363
Am J Case Rep 2024; 25:e943363
Table 1. A selected literature search (Public Library of Medicine, Medline) revealed 9 cases of ONP associated with mechanical compression of vascular structure.
Author-year | Age | Time of onset | Physical examination | MR manifestations | Treatment approaches | Prognosis |
---|---|---|---|---|---|---|
Silva 2010 []6 | 56 | 15 years | Bilateral ophthalmoplegia, partial bilateral ptosis, and no pupillary abnormalities | Bilateral oculomotor nerve compression secondary to vascular conflicts caused by the right posterior cerebral artery and left superior cerebellar artery | Refused surgery | Non-progressive |
Kheshaifati 2016 []7 | 16 | 1 year | Right third cranial nerve palsy with ptosis, moderate mydriasis | The right posterior cerebral artery loop on the external surface of the oculomotor nerve | Microvascular decompression | Recovered gradually over the next 6 months |
Jo 2015 []8 | 48 | 2 years | Complete right ONP | Low-lying right posterior cerebral artery | Not mentioned | Not mentioned |
Tan 2014 []9 | 24 | 24 hours | Complete right third cranial nerve palsy with pupil involvement | the right posterior cerebral artery had a low position | Resolved spontaneously | The symptoms spontaneously resolved 24 hours later |
Jung 2021 []10 | 56 | 23 days | Complete left ONP with ptosis, a fixed dilated pupil, and lateral and downward eyeball deviation | Left oculomotor nerve enhancement | Not mentioned | Not mentioned |
Nishino 2009 []11 | 68 | 20 months | Left ONP (ptosis and pupil dilatation), double vision | The oculomotor nerve was compressed by the aneurysm arising from the basilar-left superior cerebellar artery junction | Embolization | Nerve palsy worsened |
Fukushima 2014 []12 | 58 | 2 years | Mild left ptosis without external ophthalmoparesis or pupillary dysfunction | A point of contact between the oculomotor nerve and the infundibular dilatation of the PcomA | Clipping the infundibular dilatation at the origin of the PcomA via left frontotemporal craniotomy | Ptosis improved |
Tsutsumi 2009 []13 | 45 | Not mentioned | Complete right ONP and mild sensory loss in the first and second segments of the right fifth cranial nerve | A saccular aneurysm at the branching site of the posterior communicating artery, projecting posteriorly and adjacent to the dorsum sellae | Coil embolization of the symptomatic aneurysm | Partially improved |
Ikeda 2001 []14 | 95 | Not mentioned | third-nerve palsy without pupil involvement in the right eye | a giant aneurysm in the right anterior cavernous sinus | Not mentioned | Not mentioned |