Korean J Cerebrovasc Surg.  2005 Sep;7(3):238-240.

Oculomotor Nerve Palsy in Association with a Ruptured Internal Carotid Artery Bifurcation Aneurysm: Case Report

• Lee DS
• Kang SD
• Kim JM

Abstract

We report a rare case of third cranial nerve palsy due to a ruptured left internal carotid artery (ICA) bifurcation aneurysm. A 70-year-old man was stuporous with left ophthalmoplegia (unilaterally fixed dilated pupil, abducted eyes, and ptosis). A computed tomography demonstrated extensive hemorrhage spreading around the left sylvian fissure and basal cistern with a ipsilateral predominance, and intraventricular hemorrhage without focal mass effect. A computed tomographic angiography demonstrated a 3mm sized aneurysmal sac which arose from the left ICA bifurcation. The aneurysmal clipping was performed at 1 day after onset. In operative field, there was no direct compression of the oculomotor nerve by the aneurysmal fundus. Postoperatively, he recovered to alert mental status, but left ophthalmoplegia recovered partially at the 1 year follow-up.

Keyword

Ophthalmoplegia; Internal carotid artery bifurcation; Aneurysm

MeSH Terms

Aged
Aneurysm*
Angiography
Carotid Artery, Internal*
Follow-Up Studies
Hemorrhage
Humans
Oculomotor Nerve Diseases*
Oculomotor Nerve*
Ophthalmoplegia
Paralysis
Pupil
Stupor