Fenestrated oculomotor nerve caused by internal carotid-posterior communicating artery aneurysm: case report.

OBJECTIVE AND IMPORTANCE

The fenestrated oculomotor nerve associated with the internal carotid-posterior communicating artery aneurysm is very rare.

CLINICAL PRESENTATION

A 48-year-old woman had a history of subarachnoid hemorrhage caused by a ruptured right middle cerebral artery aneurysm, which was wrapped with good postoperative course. Twenty years later, the patient suffered frontal headache with a mild oculomotor nerve paresis in the right side. Follow-up neuroimaging studies demonstrated a de novo right internal carotid-posterior communicating artery aneurysm.

INTERVENTION

The aneurysm was exposed and clipped via a right pterional route. The fenestrated oculomotor nerve associated with the aneurysm was confirmed at surgery.

CONCLUSION

We speculated that the fenestration was most likely caused, by the growth of the aneurysm.