Unilateral oculomotor nerve palsy
Unilateral oculomotor nerve palsy, often caused by direct compression of an intracranial aneurysm, is one of the decisive findings for confirming the site of a ruptured aneurysm. However, arterial compression can also cause unilateral oculomotor nerve palsy.
Saito et al. presented the case of a 59-year-old woman with a ruptured right internal carotid-posterior communicating artery aneurysm accompanied by contralateral oculomotor nerve palsy. The nerve was found to be compressed by the posterior cerebral artery and was isolated from the ruptured aneurysm. When confirming a ruptured aneurysm based on the evidence of unilateral oculomotor palsy, the arteries surrounding the nerve must be thoroughly assessed 1)
Ishigaki T, Kitano Y, Nishikawa H, Mouri G, Shimizu S, Miya F, Suzuki H. Delayed Onset of Isolated Unilateral Oculomotor Nerve Palsy Caused by Post-Traumatic Pituitary Apoplexy: A Case Report. Clin Med Insights Case Rep. 2017 Sep 25;10:1179547617731299. doi: 10.1177/1179547617731299. eCollection 2017. PubMed PMID: 28979174; PubMed Central PMCID: PMC5617090.