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Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2020 22(2): 85-89
The Journal of Cerebrovascular and Endovascular Neurosurgery
Microvascular decompression of the posterior cerebral artery for treatment of oculomotor nerve palsy
I. Jonathan Pomeraniec1, Dale Ding2, Alexander Ksendzovsky3, Kenneth C. Liu4
1National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch, National Institutes of Health, Bethesda, MD, USA, 2Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, KY, USA, 3Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA, 4Department of Neurological Surgery, University of Southern California, Los Angeles, CA, USA

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 Cushings 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 patients 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.
Key words : Microsurgery, Microvascular decompression, Oculomotor nerve, Posterior cerebral artery, Skull base

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