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J Neurol Surg A Cent Eur Neurosurg 2013; 74(S 01): e248-e254
DOI: 10.1055/s-0033-1349330
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Perforated Oculomotor Nerve After Endovascular Coiling: Complete Regeneration After Microsurgical Repair. Case Report

Tomas Menovsky
1   Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
,
Thijs van der Zijden
2   Department of Radiology, Antwerp University Hospital, Edegem, Belgium
,
Maurits Voormolen
2   Department of Radiology, Antwerp University Hospital, Edegem, Belgium
,
Luc Van Os
3   Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
,
Gregory Helsen
4   Department of Neurology, St. Elizabeth Hospital, Edegem, Belgium
,
A. Maas
1   Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium
,
Paul M. Parizel
2   Department of Radiology, Antwerp University Hospital, Edegem, Belgium
› Author Affiliations
Further Information

Publication History

15 December 2012

22 March 2013

Publication Date:
29 July 2013 (online)

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Abstract

Background and Importance We describe a patient who developed complete right oculomotor nerve palsy after endovascular coiling for a ruptured posterior communicating artery aneurysm caused by migration of the coils outside the aneurysm.

Clinical presentation A 50-year-old woman was admitted with an acute subarachnoid hemorrhage. She underwent, on the day of admission, endovascular coiling of a ruptured posterior communicating artery aneurysm. Four hours postcoiling, complete right oculomotor nerve palsy developed because of extrusion of the coils outside the aneurysm. The patient recovered completely after surgical exploration with removal of the migrated coils and microsurgical repair of the oculomotor nerve.

Conclusion This report illustrates that oculomotor nerve palsy is a rare complication after coiling of a posterior communicating artery aneurysm, and it should serve as a reminder to encourage neurovascular teams to consider surgical exploration in cases of third nerve palsy after endovascular coiling.

Keywords

aneurysm surgery - endovascular coiling - perforation - oculomotor nerve - microsurgical repair - complication
 

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