Skip to main content
SpringerLink
Log in

Reversal of oculomotor disorders after intracranial aneurysm surgery

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Forty-nine patients with oculomotor nerve palsy due to intracranial aneurysm were examined.

The reversal of third nerve palsy is related to modality of onset and surgical timing: “early” surgery (within 14 days from the onset of oculomotor palsy) promises a better prognosis for ocular function; recovery starting within the first month will probably be complete. A full recovery is probably seen only with conduction block (neuroapraxia) or minor axonal changes (axonolysis).

Clinical features of third nerve palsy due to intracranial aneurysms versus other causes of oculomotor palsy are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Borghi G (1969) Aneurismi. In: Patologia dell'oculomotore comune nelle malattie vascolari (52nd Congresso della Societ di Oftalmologia) Milano, Rizzoli Editore, pp 307–318

    Google Scholar 

  2. Botterell EH, Lloyd LA, Hoffman HJ (1962) Oculomotor palsy due to supraclinoid internal carotid artery berry aneurysm. A long term study of the results of surgical treatments on the recovery of third nerve function. Am J Ophthalmol 54: 609–616

    Google Scholar 

  3. Fox JL (1983) Intracranial aneurysms, Vol 1. Springer, New York, pp 133–183

    Google Scholar 

  4. Fujiwara S, Fujii K, Nishio S, Matsushima T, Fukui M (1989) Oculomotor nerve palsy in patients with cerebral aneurysms. Neurosurg Rev 12: 123–132

    Google Scholar 

  5. Gray's Anatomy (1973) 35th edition. Longman 1973, 999 pp

  6. Grayson MC, Soni SR, Spooner VA (1974) Analysis of the recovery of third nerve function after direct surgical intervention for posterior communicating aneurysms. Br J Ophthalmol 58: 118–125

    PubMed  Google Scholar 

  7. Hamer J (1981) Incidence and prognosis of oculomotor palsy after subarachnoid hemorrhage due to ruptured aneurysms of the posterior communicating artery. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York Tokyo, pp 226–228

    Google Scholar 

  8. Hepler RS, Cantu RC (1967) Aneurysms and third nerve palsies. Ocular status of survivors. Arch Ophthalmol 77: 604–608

    Google Scholar 

  9. Kasoff I, Kelly DL (1975) Pupillary sparing in oculomotor palsy from internal carotid aneurysm. Case report. J Neurosurg 42: 713–717

    PubMed  Google Scholar 

  10. Keane JR (1983) Aneurysm and third nerve palsies. Ann Neurol 14: 606–697

    Google Scholar 

  11. Kerns JM, Smith DR, Jannotta FS, Alper MG (1979) Oculomotor nerve regeneration after aneurysm surgery. Am J Ophthalmol 87: 225–233

    PubMed  Google Scholar 

  12. Kerr F, Hollowell OW (1964) Location of pupillomotor and accomodation fibers in the oculomotor nerve: experimental observation on paralytic midriasis. J Neurol Neurosurg Psychiatry 27: 473–481

    PubMed  Google Scholar 

  13. Kissel JT, Burde RM, Klingele TG, Zeiger HE (1983) Pupilsparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms. Ann Neurol 13: 149–154

    PubMed  Google Scholar 

  14. Kwan ESK, Lancella M, Hedges III TR, Volpert SM (1987) A cliniconeuroradiological approach to third cranial nerve palsies. AJNR 8: 459–468

    PubMed  Google Scholar 

  15. O'Connor PS, Tredici TJ, Green RP (1983) Pupillary-sparing third nerve palsy due to aneurysms: a survey of 2419 neurological surgeons (Letter). J Neurosurg 58: 792–793

    PubMed  Google Scholar 

  16. Raya I (1972) Aneurysm-induced third nerve palsy. J Neurosurg 36: 548–551

    PubMed  Google Scholar 

  17. Rush JA, Younge BR (1981) Paralysis of cranial nerves III, IV, and VI. Cause and prognosis in 1000 cases. Arch Ophthalmol 99: 76–79

    PubMed  Google Scholar 

  18. Serdaru M, Schaison M, Lhermitte F (1983) Pupil sparing in oculomotor palsy and Claude Bernard Horner syndrome. Ann Neurol 14: 697

    PubMed  Google Scholar 

  19. Soni SR (1974) Aneurysms of the posterior communicating artery and oculomotor paresis. J Neurol Neurosurg Psychiatry 37: 475–484

    PubMed  Google Scholar 

  20. Sunderland S, Hughes ESR (1946) The pupillo-constrictor pathway and the nerves to the ocular muscles in man. Brain 69: 301–309

    Google Scholar 

  21. Suzuki J, Iwabuchi T (1974) Ocular motor disturbances occurring as false localizing signs in ruptured intracranial aneurysms. Acta Neurochir (Wien) 30: 119–128

    Google Scholar 

  22. Suzuki J, Mizoi K, Sato T (1981) Disturbances of ocular movements due to cerebral aneurysm. Based upon the experience in 1000 directly operated patients. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York Tokyo, pp 226–228

    Google Scholar 

  23. Zuelch KJ (1981) Pathomechanism of oculomotor and abducens paresis in supra and infratentorial processes. In: Samii M, Jannetta PJ (eds) The cranial nerves. Springer, Berlin Heidelberg New York Tokyo, pp 226–228

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divisione di Neurochirurgia, Ospedali Riuniti, Bergamo, Italy

    S. Giombini, S. Ferraresi & F. Pluchino

  2. Divisione di Neurochirurgia, Istituto Neurologico C, Besta, Milan, Italy

    S. Giombini & F. Pluchino

Authors
  1. S. Giombini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Ferraresi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Pluchino
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giombini, S., Ferraresi, S. & Pluchino, F. Reversal of oculomotor disorders after intracranial aneurysm surgery. Acta neurochir 112, 19–24 (1991). https://doi.org/10.1007/BF01402449

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01402449

Keywords

Search

Navigation