Microvascular Decompression for Oculomotor Nerve Palsy Due to Nonaneurysmal Neurovaslur Conflict: 5 Cases Report and Literature Review

• Published in: World neurosurgery 2024-11, Vol.191, p.e356-e364
• Main Authors: Zhao, Hua, Wang, Baimiao, Tang, Yinda, Li, Shiting
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Humans; Male; Microvascular decompression; Microvascular Decompression Surgery - methods; Middle Aged; Neurovascular conflict; Oculomotor Nerve Diseases - etiology; Oculomotor Nerve Diseases - surgery; Oculomotor nerve palsy
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.08.130

Oculomotor nerve palsy (ONP) is frequently caused by aneurysm compression and diabetes mellitus. However, nonaneurysmal compression (nAVC) of the oculomotor nerve is a condition rarely reported in the literature. Cases treated with microvascular decompression (MVD) for nAVC-induced ONP (nAVC-ONP) are exceptionally rare. Between October 2022 and October 2023, we performed MVD surgery on 5 patients diagnosed with nAVC-ONP. The clinical symptoms, imaging characteristics, and intraoperative findings of these patients were reviewed and analyzed using a self-developed evaluation scale (S-T Evaluation Scale) to guide diagnosis and corresponding treatment plans. All patients underwent MVDs and demonstrated favorable recovery and a good prognosis. No postoperative complications occurred in any of the patients. The superior cerebellar artery and posterior cerebral artery were common offending vessels in these cases. Neurovascular conflict has been proposed as another possible cause of ONP in a limited number of cases. Based on our findings, MVD is a potentially effective solution for patients experiencing oculomotor nerve palsy resulting from nonaneurysmal neurovascular conflicts. It holds great promise for significantly alleviating symptoms and improving overall quality of life.