Journal of neurosurgery. Case lessons · 2026
Recovery of oculomotor nerve palsy following Woven EndoBridge treatment for a symptomatic basilar artery-superior cerebellar artery junction aneurysm: illustrative case.
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Agawa Yuji, Hatano Taketo
Аннотация
BACKGROUND: Recovery of oculomotor nerve palsy (ONP) caused by an unruptured intracranial aneurysm has been reported after microsurgical clipping and endovascular coiling. However, ONP recovery following treatment with the Woven EndoBridge (WEB) device has not previously been described.
OBSERVATIONS: A woman in her late 80s with a known left basilar artery-superior cerebellar artery (SCA) junction aneurysm, initially managed conservatively because of advanced age, developed progressive left incomplete ONP with ptosis and impaired extraocular movement after aneurysm enlargement. MRI demonstrated an enlarging 10-mm aneurysm with an enhancing apical bleb. Initial WEB SL deployment failed, but balloon-assisted deployment with Neuroform Atlas stent stabilization enabled successful WEB placement while preserving the SCA. The postoperative course was uneventful, and the patient was discharged on postoperative day 4. Complete ONP resolution was achieved at 1 month. A 3-month angiography study demonstrated WEB Occlusion Scale grade C with preserved SCA patency.
LESSONS: WEB treatment may be an effective option for selected symptomatic aneurysms. Flow disruption while preserving the aneurysm dome adjacent to the oculomotor nerve may have contributed to the complete recovery of ONP. https://thejns.org/doi/10.3171/CASE26637.
OBSERVATIONS: A woman in her late 80s with a known left basilar artery-superior cerebellar artery (SCA) junction aneurysm, initially managed conservatively because of advanced age, developed progressive left incomplete ONP with ptosis and impaired extraocular movement after aneurysm enlargement. MRI demonstrated an enlarging 10-mm aneurysm with an enhancing apical bleb. Initial WEB SL deployment failed, but balloon-assisted deployment with Neuroform Atlas stent stabilization enabled successful WEB placement while preserving the SCA. The postoperative course was uneventful, and the patient was discharged on postoperative day 4. Complete ONP resolution was achieved at 1 month. A 3-month angiography study demonstrated WEB Occlusion Scale grade C with preserved SCA patency.
LESSONS: WEB treatment may be an effective option for selected symptomatic aneurysms. Flow disruption while preserving the aneurysm dome adjacent to the oculomotor nerve may have contributed to the complete recovery of ONP. https://thejns.org/doi/10.3171/CASE26637.