Microvascular decompression of the posterior cerebral artery for treatment of oculomotor nerve palsy

• Published in: Journal of cerebrovascular and endovascular neurosurgery Vol. 22; no. 2; pp. 85 - 89
• Main Authors: Pomeraniec, I. Jonathan, Ding, Dale, Ksendzovsky, Alexander, Liu, Kenneth C.
• Format: Journal Article
• Language: English
• Published: KSCVS and KoNES 01-06-2020; 대한뇌혈관외과학회
• Subjects: Case Report; 신경외과학
• ISSN: 2234-8565; 2287-3139
• DOI: 10.7461/jcen.2020.22.2.85

Oculomotor nerve palsy resulting from non-aneurysmal vascular compression is extremely rare. Microvascular decompression (MVD) has been previously shown to improve oculomotor nerve palsy (ONP) secondary to arterial compression. A 71-year-old female, with a history of Cushing’s disease previously treated with two transsphenoidal resections and Gamma Knife radiosurgery, presented with one year of progressive left eye diplopia and was diagnosed with a partial left oculomotor nerve palsy. We performed an orbitozygomatic craniotomy for MVD of the left posterior cerebral artery, which was found to be compressing the oculomotor nerve against the tentorium. Unfortunately, the patient’s partial ONP remained unchanged at one year follow-up. The present case suggests inconsistent outcomes of MVD for ONP. Patients with prior sellar or parasellar irradiation may be less likely to benefit from this treatment approach.