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Microvascular Decompression for Oculomotor Nerve Palsy: A Case Report and Literature Review.
World Neurosurg. 2016 Apr; 88:695.e1-695.e3.WN

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.

CASE DESCRIPTION

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+Show Affiliations

Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Electronic address: dr.hussein.kh@gmail.com.Division of Neurosurgery, Neuroscience Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Medical School, Lebanese American University, Beirut, Lebanon.Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

26850973

Citation

Kheshaifati, Hussein, et al. "Microvascular Decompression for Oculomotor Nerve Palsy: a Case Report and Literature Review." World Neurosurgery, vol. 88, 2016, pp. 695.e1-695.e3.
Kheshaifati H, Al-Otaibi F, Alhejji M. Microvascular Decompression for Oculomotor Nerve Palsy: A Case Report and Literature Review. World Neurosurg. 2016;88:695.e1-695.e3.
Kheshaifati, H., Al-Otaibi, F., & Alhejji, M. (2016). Microvascular Decompression for Oculomotor Nerve Palsy: A Case Report and Literature Review. World Neurosurgery, 88, e1-e3. https://doi.org/10.1016/j.wneu.2015.12.083
Kheshaifati H, Al-Otaibi F, Alhejji M. Microvascular Decompression for Oculomotor Nerve Palsy: a Case Report and Literature Review. World Neurosurg. 2016;88:695.e1-695.e3. PubMed PMID: 26850973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Microvascular Decompression for Oculomotor Nerve Palsy: A Case Report and Literature Review. AU - Kheshaifati,Hussein, AU - Al-Otaibi,Faisal, AU - Alhejji,Maher, Y1 - 2016/02/02/ PY - 2015/08/25/received PY - 2015/12/23/revised PY - 2015/12/24/accepted PY - 2016/2/7/entrez PY - 2016/2/7/pubmed PY - 2016/8/23/medline KW - Microvascular decompression KW - Oculomotor palsy SP - 695.e1 EP - 695.e3 JF - World neurosurgery JO - World Neurosurg VL - 88 N2 - 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. CASE DESCRIPTION: 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. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/26850973/Microvascular_Decompression_for_Oculomotor_Nerve_Palsy:_A_Case_Report_and_Literature_Review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(15)01790-8 DB - PRIME DP - Unbound Medicine ER -