Consecutive oculomotor nerve palsy from a de novo cerebral aneurysm.
A 26-year-old woman presented with a partial left oculomotor nerve palsy and an acute subarachnoid hemorrhage. Bilateral angiography showed a left posterior communicating artery aneurysm and a normal right anterior circulation. The aneurysm was successfully clipped. At 4 1/2 years later, she had an acute, nearly complete, right oculomotor nerve palsy. Repeat bilateral angiography showed a right posterior communicating artery aneurysm, in a previously angiographically normal region, and continued closure of the original left-sided aneurysm. New aneurysms may develop from angiographically normal locations. It is possible that certain patients are more susceptible than average to aneurysm formation or that aneurysm repair leads to a higher rate of new aneurysm occurrence. The previous cases of de novo aneurysms are summarized and the implications for repeat aneurysm screening, using current technology, are discussed.
Striph
G G
GG
Department of Surgery, Toledo Hospital, Ohio.
D000328:Adult; D002536:Cerebral Arteries / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000209:etiology