• Internal medicine · Oct 2024

    Pupil-sparing isolated inferior rectus paresis due to compression of the oculomotor nerve by the posterior cerebral artery.

    • Yukitaka Ishida, Yasunori Fujimoto, Ryuichiro Kajikawa, Yu Kageyama, Yohei Bamba, and Ayaka Ichise.
    • Department of Neurosurgery, Osaka Rosai Hospital, Japan.
    • Intern. Med. 2024 Oct 18.

    AbstractDirect compression of the oculomotor nerve (OcN) is usually accompanied by OcN palsy (OcNP), with an abnormal pupillary function. We herein present the case of a 76-year-old man with pupil-sparing paresis of the right inferior rectus muscle. A radiological examination revealed an epidermoid cyst at the right cerebellopontine angle, which came in contact with the right oculomotor nerve. However, surgical intervention revealed compression of the inferomedial aspect of the oculomotor nerve by the right posterior cerebral artery. Decompression of the nerve gradually improved the ocular movement. This unique case offers insights into the potential topographical arrangement of the oculomotor nerve fibers.

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