Journal of neurological surgery. Part A, Central European neurosurgery · 2013
Perforated oculomotor nerve after endovascular coiling: complete regeneration after microsurgical repair. case report.
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Menovsky Tomas, van der Zijden Thijs, Voormolen Maurits, Van Os Luc, Helsen Gregory, Maas A, Parizel Paul M
Аннотация
BACKGROUND AND IMPORTANCE: We describe a patient who developed complete right oculomotor nerve palsy after endovascular coiling for a ruptured posterior communicating artery aneurysm caused by migration of the coils outside the aneurysm.
CLINICAL PRESENTATION: A 50-year-old woman was admitted with an acute subarachnoid hemorrhage. She underwent, on the day of admission, endovascular coiling of a ruptured posterior communicating artery aneurysm. Four hours postcoiling, complete right oculomotor nerve palsy developed because of extrusion of the coils outside the aneurysm. The patient recovered completely after surgical exploration with removal of the migrated coils and microsurgical repair of the oculomotor nerve.
CONCLUSION: This report illustrates that oculomotor nerve palsy is a rare complication after coiling of a posterior communicating artery aneurysm, and it should serve as a reminder to encourage neurovascular teams to consider surgical exploration in cases of third nerve palsy after endovascular coiling.
CLINICAL PRESENTATION: A 50-year-old woman was admitted with an acute subarachnoid hemorrhage. She underwent, on the day of admission, endovascular coiling of a ruptured posterior communicating artery aneurysm. Four hours postcoiling, complete right oculomotor nerve palsy developed because of extrusion of the coils outside the aneurysm. The patient recovered completely after surgical exploration with removal of the migrated coils and microsurgical repair of the oculomotor nerve.
CONCLUSION: This report illustrates that oculomotor nerve palsy is a rare complication after coiling of a posterior communicating artery aneurysm, and it should serve as a reminder to encourage neurovascular teams to consider surgical exploration in cases of third nerve palsy after endovascular coiling.