Ptosis as partial oculomotor nerve palsy due to compression by infundibular dilatation of posterior communicating artery, visualized with three-dimensional computer graphics: case report

Neurol Med Chir (Tokyo). 2014;54(3):214-8. doi: 10.2176/nmc.cr2012-0383. Epub 2013 Nov 8.

Abstract

Oculomotor nerve palsy (ONP) due to internal carotid-posterior communicating artery (PcomA) aneurysm generally manifests as partial nerve palsy including pupillary dysfunction. In contrast, infundibular dilatation (ID) of the PcomA has no pathogenic significance, and mechanical compression of the cranial nerve is extremely rare. We describe a 60-year-old woman who presented with progressive ptosis due to mechanical compression of the oculomotor nerve by an ID of the PcomA. Three-dimensional computer graphics (3DCG) accurately visualized the mechanical compression by the ID, and her ptosis was improved after clipping of the ID. ID of the PcomA may cause ONP by mechanical compression and is treatable surgically. 3DCG are effective for the diagnosis and preoperative simulation.

Publication types

  • Case Reports

MeSH terms

  • Angiography, Digital Subtraction
  • Blepharoptosis / diagnosis*
  • Blepharoptosis / surgery
  • Cerebral Angiography
  • Computer Graphics*
  • Computer Simulation
  • Dilatation, Pathologic / diagnosis
  • Dilatation, Pathologic / surgery
  • Female
  • Humans
  • Image Enhancement
  • Imaging, Three-Dimensional*
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / surgery
  • Magnetic Resonance Angiography
  • Microsurgery
  • Middle Aged
  • Nerve Compression Syndromes / diagnosis*
  • Nerve Compression Syndromes / surgery
  • Oculomotor Nerve Diseases / diagnosis*
  • Oculomotor Nerve Diseases / surgery
  • Pituitary Gland / pathology*
  • Pituitary Gland / surgery
  • Surgical Instruments