Recurrent Oculomotor Neurovascular Conflict Caused by Fetal Posterior Cerebral Artery: Case Report And Review of Literature

Authors

  • Mohammed Sabawi Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, USA
  • Jacob A Schroeder Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, USA
  • Fausto Carlos Dier Melo Department of Neurology, University of Iowa Hospitals and Clinics, USA
  • Márcio Luís Duarte [1]Department of Radiology, Universidade de Ribeirão Preto - Campus Guarujá, Guarujá, Brazil and [2]Department of Radiology, Diagnósticos da América S.A., Brazil
  • Nitesh Shekhrajka Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, USA
  • Leonardo Furtado Feritas Division of Neuroradiology, Department of Radiology, University of Iowa Hospitals and Clinics, USA

DOI:

https://doi.org/10.3941/jrcr.5418

Abstract

Neurovascular conflict, often asymptomatic, necessitates investigation when neuropathy is suspected. Oculomotor nerve involvement is rare, commonly attributed to microvascular issues, trauma, tumors, or surgery. Arterial conflicts are typically more symptomatic. Clinical presentation includes ptosis and muscle paralysis, with pupillary asymmetry indicating compression of specific nerve areas. Imaging advancements aid in detection, highlighting vessels like the PCA, SCA, Pcom, and ICA, along with anatomical variants. Differential diagnoses encompass various vascular, infectious, inflammatory, and neoplastic conditions. Treatment begins with medical management, using steroids or carbamazepine, with microvascular decompression as a surgical option in persistent cases. Careful consideration is needed due to surgical risks. We aim to present an uncommon oculomotor neurovascular conflict caused by fetal posterior cerebral artery detected by aCT scan and MRI.

54-year-old male presenting with oculomotor neurovascular conflict. Brain MRA on axial 3D-TOF sequence (A-C)

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Published

2024-09-29

Issue

Vol. 18 No. 9 (2024)

Section

Neuroradiology

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