Microvascular decompression for long-standing oculomotor nerve palsy due to compression by fetal-type posterior communicating artery.
Marco Cenzato, Giacomo Petrella, Francesco Iovino et al.
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Case in brief
A woman with a 2-year history of left-sided ptosis and binocular horizontal diplopia was diagnosed with oculomotor nerve palsy due to compression from a fetal-type posterior communicating artery. After conservative treatments failed, she underwent microvascular decompression via a left pterional approach. The procedure successfully resolved her symptoms by the third week postoperatively.
What made this case unusual
The case illustrates a rare instance of symptomatic non-aneurysmal neurovascular compression causing long-standing oculomotor nerve palsy, which is often underdiagnosed.
Diagnostic / clinical pearl
Clinicians should consider neurovascular compression as a potential cause of unexplained oculomotor nerve palsy, even after prolonged symptom duration.
Why it matters
This case underscores the effectiveness of microvascular decompression in treating long-standing oculomotor nerve palsy due to neurovascular compression.