Cavernous Sinus Right Internal Carotid Artery Aneurysm With Ipsilateral Oculomotor Nerve Palsy: A Case Report

Oculomotor nerve palsy, characterized by symptoms such as ptosis and restricted extraocular movements, can be a manifestation of an intracranial aneurysm. While it is commonly associated with the posterior communicating artery, it can also arise from other vascular structures, such as the internal carotid artery (ICA). We present a 61-year-old female patient with hypertension, hyperlipidemia, and a two-year history of right-sided strabismus who presented with complaints of weakness, right-sided headache, which was ongoing for two days, as well as right-sided ptosis. Her symptoms led to the rediscovery of an ICA aneurysm within the cavernous sinus. This aneurysm was subsequently treated with flow diversion; however, it left the patient with residual ptosis and decreased extraocular movement (EOM). This case emphasizes the importance of consistent follow-up in patients with known vascular abnormalities affecting the cranial nerves.