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08:22

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Published on: July 21, 2013

Complete oculomotor palsy caused by persistent trigeminal artery.

Domenico Bosco1, Domenico Consoli, Pier Luigi Lanza

  • 1Department of Neuroscience, S. Giovanni di Dio Hospital, Via Largo Bologna, 88900, Crotone, Italy. nico_bosco@libero.it

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|June 17, 2010
PubMed
Summary

A persistent primitive trigeminal artery (PTA) can cause oculomotor nerve palsy. This case report details a rare instance of complete third cranial nerve palsy linked to a PTA, highlighting a potential neurovascular conflict.

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Area of Science:

  • Neuroscience
  • Vascular Neurology
  • Embryology

Background:

  • The primitive trigeminal artery (PTA) represents the most common embryonic connection between the carotid and vertebro-basilar arterial systems.
  • PTA is recognized as a rare cause of cranial nerve dysfunction due to its pathophysiology.
  • Understanding PTA's role in neurovascular conflicts is crucial for diagnosing rare neurological conditions.

Observation:

  • A 40-year-old woman presented with complete oculomotor nerve palsy.
  • Brain Magnetic Resonance Angiography (MRA) revealed a neurovascular conflict involving the oculomotor nerve and a persistent ecstatic trigeminal artery.
  • This presentation signifies a rare etiology for third cranial nerve palsy.

Findings:

  • The study documents a unique case of complete oculomotor nerve palsy directly attributed to a persistent ecstatic trigeminal artery.
  • Neuroimaging confirmed a distinct neurovascular conflict between the affected cranial nerve and the anomalous artery.
  • This represents the first reported case of complete third cranial nerve palsy caused by a PTA.

Implications:

  • This case underscores the importance of considering PTA in the differential diagnosis of oculomotor nerve palsy, especially in the absence of other common causes.
  • The findings suggest that PTA-induced neurovascular compression can lead to significant cranial nerve dysfunction.
  • Further research into the specific mechanisms and prevalence of PTA-related cranial nerve palsies is warranted.