Clinical Features of Unruptured Internal Carotid Artery Aneurysms Presenting with Oculomotor Nerve Palsy

Abstract

Intracranial aneurysms are sometimes associated with oculomotor nerve palsy. We report five surgical cases of unruptured internal carotid-posterior communicating artery aneurysms presenting with oculomotor nerve palsy. In such cases, the internal carotid artery runs closely to the skull base, reducing the operative field around the aneurysm. Therefore, anterior clinoid process drilling or a cerebellar tent incision should be performed, if necessary, to ensure safe operative maneuvers. The distance between the internal carotid artery and anterior-posterior clinoid process may be a useful preoperative indicator for tent incisions.