Pupil-sparing oculomotor nerve paresis as an early symptom of unruptured internal carotid-posterior communicating artery aneurysms: three case reports.
Oculomotor nerve paresis caused by internal carotid-posterior communicating artery (IC-PC) aneurysm usually manifests with pupillary dysfunction. Recently, we treated three patients with unruptured IC-PC aneurysms initially manifesting as pupil-sparing oculomotor nerve paresis, which resolved after clipping of the aneurysms. Review of the 56 patients admitted to our hospital with unruptured IC-PC aneurysms between January 2000 and December 2006 identified 6 patients with oculomotor nerve disturbances, and the 3 present cases with pupil sparing. The incidence of IC-PC aneurysms manifesting as pupil-sparing oculomotor nerve paresis may be increasing with improved accessibility to medical services and wider awareness of oculomotor nerve paresis as a symptom of cerebral aneurysms. Cerebral angiography should be performed in patients with pupil-sparing oculomotor nerve paresis.
Saito
Ryuta
R
Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan. ryuta@nsg.med.tohoku.ac.jp
Sugawara
Takayuki
T
Mikawa
Sigeki
S
Fukuda
Takeshi
T
Kohama
Misaki
M
Seki
Hirobumi
H
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis* / Q000601:surgery; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002533:Cerebral Angiography; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology* / Q000601:surgery; D012025:Reflex, Pupillary / Q000502:physiology*