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19 May 2024 : Case report  China (mainland)

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-yearAgeTime of onsetPhysical examinationMR manifestationsTreatment approachesPrognosis
Silva 2010 []6 5615 yearsBilateral ophthalmoplegia, partial bilateral ptosis, and no pupillary abnormalitiesBilateral oculomotor nerve compression secondary to vascular conflicts caused by the right posterior cerebral artery and left superior cerebellar arteryRefused surgeryNon-progressive
Kheshaifati 2016 []7 161 yearRight third cranial nerve palsy with ptosis, moderate mydriasisThe right posterior cerebral artery loop on the external surface of the oculomotor nerveMicrovascular decompressionRecovered gradually over the next 6 months
Jo 2015 []8 482 yearsComplete right ONPLow-lying right posterior cerebral arteryNot mentionedNot mentioned
Tan 2014 []9 2424 hoursComplete right third cranial nerve palsy with pupil involvementthe right posterior cerebral artery had a low positionResolved spontaneouslyThe symptoms spontaneously resolved 24 hours later
Jung 2021 []10 5623 daysComplete left ONP with ptosis, a fixed dilated pupil, and lateral and downward eyeball deviationLeft oculomotor nerve enhancementNot mentionedNot mentioned
Nishino 2009 []11 6820 monthsLeft ONP (ptosis and pupil dilatation), double visionThe oculomotor nerve was compressed by the aneurysm arising from the basilar-left superior cerebellar artery junctionEmbolizationNerve palsy worsened
Fukushima 2014 []12 582 yearsMild left ptosis without external ophthalmoparesis or pupillary dysfunctionA point of contact between the oculomotor nerve and the infundibular dilatation of the PcomAClipping the infundibular dilatation at the origin of the PcomA via left frontotemporal craniotomyPtosis improved
Tsutsumi 2009 []13 45Not mentionedComplete right ONP and mild sensory loss in the first and second segments of the right fifth cranial nerveA saccular aneurysm at the branching site of the posterior communicating artery, projecting posteriorly and adjacent to the dorsum sellaeCoil embolization of the symptomatic aneurysmPartially improved
Ikeda 2001 []14 95Not mentionedthird-nerve palsy without pupil involvement in the right eyea giant aneurysm in the right anterior cavernous sinusNot mentionedNot mentioned

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923