title: Microvascular Decompression for Oculomotor Nerve Palsy: A Case Report and Literature Review.
abstract: BACKGROUND
  Oculomotor nerve palsy can result as a manifestation of diabetic mellitus or aneurysmal compression. Vascular loop compression is a very rare etiology of oculomotor nerve palsy. Here, we present a case report of microvascular decompression for oculomotor nerve palsy.
  
  
  METHODS
  We present a 16-year-old male patient, otherwise healthy, who presented with right oculomotor nerve palsy for a period of 1 year. Aneurysmal compression and intracranial lesion were ruled out by cerebral angiogram and magnetic resonance imaging. The presence of vessel loop compression on the nerve was suspected on the basis of features on magnetic resonance imaging. The patient underwent microvascular decompression via a right subtemporal approach. We intraoperatively confirmed vessel loop compression at the exit zone of the nerve from midbrain. Subsequently, the patient's oculomotor palsy has improved gradually over a period of 6 months.
  
  
  CONCLUSIONS
  Vascular compression of the oculomotor nerve is a very rare finding in neurosurgical practice. A diagnosis of vascular compression is made by excluding other pathologies and using high-resolution images that visualize the nerve and the offending vessel loop. Microvascular decompression can be an effective treatment method for this condition.
authors: Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Electronic address: dr.hussein.kh@gmail.com.
authors: Hussein
authors: H
authors: Kheshaifati
authors: Division of Neurosurgery, Neuroscience Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Medical School, Lebanese American University, Beirut, Lebanon.
authors: Faisal
authors: F
authors: Al-Otaibi
authors: Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
authors: Maher
authors: M
authors: Alhejji
mesh_terms: D000293:Adolescent; D019299:Decompression, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D055806:Microvessels / Q000601:surgery; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Microvascular decompression; Oculomotor palsy