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Skull Base 2002; 12(3): 141-144
DOI: 10.1055/s-2002-33460
CASE REPORT

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Abnormal Course of the Oculomotor Nerve on the Clivus Combined with a Petroclival Meningioma: Case Report

Masateru Katayama1 , Takeshi Kawase1 , Shuzo Sato1 , Atsuhiro Kojima1 , Kazunari Yoshida1
  • 1Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan
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Publication History

Publication Date:
21 August 2002 (online)

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ABSTRACT

The course of the oculomotor nerve on the clivus was abnormal in a patient with petroclival meningioma. He complained of gait disturbance. A gadolinium-enhanced magnetic resonance image demonstrated a 4.4-cm enhancing mass in the petroclival region. The tumor was removed via an anterior transpetrosal-transtentorial approach. Normally, the oculomotor nerve originates from the brainstem and enters the oculomotor trigone. In this patient, the oculomotor nerve entered the dura mater at the upper clivus, behind the posterior clinoid process, and coursed parallel to the basilar artery. This entrance is lower than the normal entry point of the oculomotor nerve. The abnormal entrance of the oculomotor nerve may reflect an atypical developmental relationship among the cranial nerves, meninges, and bones during embryogenesis.

KEYWORDS

Petroclival meningioma - anatomical variation - oculomotor nerve - microanatomy - anterior transpetrosal-transtentorial approach

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