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Neuropediatrics Jun 2000Transient oculomotor nerve palsy is rarely observed in childhood and mostly is recognized to be a migraine equivalent. We report an 8-year old girl who presented with... (Review)
Review
Transient oculomotor nerve palsy is rarely observed in childhood and mostly is recognized to be a migraine equivalent. We report an 8-year old girl who presented with recurrent attacks of transient oculomotor paresis. The clinical profile of the patient suggested transient dysfunction in the context of an ophthalmoplegic migraine. A CT scan was normal, but MRI demonstrated a swollen right oculomotor nerve.
Topics: Child; Female; Humans; Magnetic Resonance Imaging; Migraine Disorders; Oculomotor Nerve; Ophthalmoplegia
PubMed: 10963102
DOI: 10.1055/s-2000-7532 -
Child's Nervous System : ChNS :... Jun 2011Endoscopic third ventriculostomy (ETV) has become first-line treatment for obstructive hydrocephalus. Many complications have been described, but the literature about... (Comparative Study)
Comparative Study
PURPOSE
Endoscopic third ventriculostomy (ETV) has become first-line treatment for obstructive hydrocephalus. Many complications have been described, but the literature about oculomotor palsy after ETV is scarce. Therefore we undertook an anatomical study of the relationship of the oculomotor nerve to the floor of the third ventricle.
METHODS
Distances and angles between the third nerve and the bottom of the third ventricle were studied both in two cadaver heads and in high-definition CISS images in 16 MRI scans. The angles of the trajectories putting the nerve at risk or not were compared. Finally, in a retrospective analysis of intraoperative images the appearance of the membranous portion of the floor was defined and if visible, the distance of the third nerve to the midline was estimated by comparing with the 8-mm balloon catheter.
RESULTS
The course of the third nerve is approximately 8 mm laterally and approximately 17 mm caudally distant from the midpoint of the floor of the third ventricle. The angle of the trajectory to damage the third nerve is at least 12° greater than any safe angle of ETV trajectory through a normal burr hole.
CONCLUSIONS
The third nerve is not always visible during ETV procedures, but the angular and linear measurements imply that the risk to damage the nerve should be relatively small. Confirmation of these data in hydrocephalic patients with distorted anatomy is needed.
Topics: Humans; Neuroendoscopy; Oculomotor Nerve; Retrospective Studies; Third Ventricle; Ventriculostomy
PubMed: 21240510
DOI: 10.1007/s00381-010-1317-5 -
Clinical Anatomy (New York, N.Y.) Jul 2011In this study, the arterial supply of the cisternal (initial) and the subcavernous parts of the oculomotor nerve (ON) and the relation between the nerve and adjacent...
In this study, the arterial supply of the cisternal (initial) and the subcavernous parts of the oculomotor nerve (ON) and the relation between the nerve and adjacent vascular structures like posterior cerebral artery (PCA) and superior cerebellar artery (SCA) were investigated. A total of 140 formalin fixed hemispheres from 70 human cadaveric brains were examined. The nutrient branches reaching the cisternal and subcavernous parts of the ON were investigated, along with branches of adjacent vascular structures penetrating the nerve and passing through it. In the material examined, the ON, after arising from the midbrain, mostly continues laterally between PCA and SCA or between PCA and the rostral SCA trunk. However, in three hemispheres of our specimens, the ON run between the rostral and caudal SCA trunks. We observed that the branches of PCA-P1 segment supplied the cisternal part of the ON in all specimens. In one specimen, the cisternal part of the ON was supplied by a branch arising from the rostral SCA trunk which was also originating from PCA. Differently, in four hemispheres, branches arising from PCA or SCA perforated the cisternal part of the ON and passed through it. We also observed a tortuous caudal trunk of duplicated SCA in one of our specimens and considered it as a rare variation. The anatomy of the ON and its vascular relations is significant in terms of not only understanding the compression syndromes and its vascular dysfunctions, but the exact diagnosis and treatment as well.
Topics: Basilar Artery; Brain; Cadaver; Humans; Oculomotor Nerve; Posterior Cerebral Artery
PubMed: 21254247
DOI: 10.1002/ca.21111 -
Neuroimaging Clinics of North America Aug 2015Eye movement is controlled by ocular motor pathways that encompass supranuclear, nuclear, and infranuclear levels. Lesions affecting certain locations may produce... (Review)
Review
Eye movement is controlled by ocular motor pathways that encompass supranuclear, nuclear, and infranuclear levels. Lesions affecting certain locations may produce localizing signs that help radiologists focus on specific anatomic regions. Some pathologic conditions, such as aneurysms and meningiomas, have unique imaging characteristics that may preclude unnecessary tissue biopsies. Some conditions are life threatening and require urgent or emergent imaging. MR imaging is the imaging of choice in evaluation of ocular motor palsy, with magnetic resonance angiography or computed tomography angiography indicated in cases of suspected aneurysms or neurovascular conflicts.
Topics: Angiography; Cranial Nerve Neoplasms; Humans; Nerve Compression Syndromes; Neuroimaging; Oculomotor Nerve; Oculomotor Nerve Diseases; Oculomotor Nerve Injuries
PubMed: 26208418
DOI: 10.1016/j.nic.2015.05.006 -
Surgical and Radiologic Anatomy : SRA Mar 2017The cisternal segments of the oculomotor nerve (OMN), which courses through the interpeduncular and oculomotor cisterns (OMC) have not been well delineated on...
PURPOSE
The cisternal segments of the oculomotor nerve (OMN), which courses through the interpeduncular and oculomotor cisterns (OMC) have not been well delineated on neuroimages. The present study aimed to explore the cisternal segments of the OMN using magnetic resonance (MR) imaging.
METHODS
A total of 92 patients were enrolled in this study. A constructive interference in steady-state sequence was performed in coronal and axial sections.
RESULTS
On coronal images, cisternal portions of the OMN were entirely delineated in 97 % on the right and in 98.5 % on the left. Most of the OMCs were of a round shape, with a centrally located OMN, while 9 % were ectatic with the OMN located eccentrically. In 5.3 % of cases, fetal-type posterior communicating arteries (PCoAs), which coursed adjacent to the superior surfaces of the OMNs at the oculomotor triangle (OMT), were observed. On axial images, cisternal portions of the OMN were identified in all cases. The OMN segment passing through the OMT showed medial, central, and lateral courses. The PCoAs and P2 segments of the posterior cerebral artery (PCA) were adjacent to the OMNs in 17 and 19 % of cases, respectively.
CONCLUSIONS
The OMN most frequently courses in the medial part of the OMT and enters into the OMC. These findings indicate that OMN paresis can be caused by vascular compression at any site of the interpeduncular cistern and OMT.
Topics: Adolescent; Adult; Aged; Child; Circle of Willis; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Oculomotor Nerve; Posterior Cerebral Artery; Retrospective Studies; Young Adult
PubMed: 27438023
DOI: 10.1007/s00276-016-1725-7 -
Child's Nervous System : ChNS :... May 2010The objective of this study is to define the endoscopic anatomy of the oculomotor nerve (CN III) and its neurovascular relations in order to facilitate surgical...
OBJECTIVE
The objective of this study is to define the endoscopic anatomy of the oculomotor nerve (CN III) and its neurovascular relations in order to facilitate surgical procedures and avoid injury to this nerve during endoscopic endonasal approach to the skull base.
MATERIALS AND METHODS
Endoscopic anatomy of the cavernous sinus was studied in seven fresh adult cadavers bilaterally and the basal cisterns in five fresh adult cadavers. Extended endoscopic endonasal suprasellar approach was performed to expose the oculomotor nerve in the interpeduncular cistern and the endoscopic endonasal transethmoidopterygoidosphenoidal approach to expose the oculomotor nerve within the cavernous sinus.
RESULTS
The extraorbital part of the oculomotor nerve can be divided into three segments in regard to the cisterns and venous spaces that are being transected: the interpeduncular segment, the cisternal segment, and the intercavernous segment. Of these segments, only the cisternal segment could not be exposed since this segment was located at the initial part of the roof of the cavernous sinus, anterolateral to the posterior clinoid, and posteroinferior to the anterior clinoid processes. Thus, cisternal segment of the oculomotor nerve was considered a blind spot during endoscopic approaches to the skull base.
CONCLUSION
We defined the endoscopic anatomy of the CN III and the related neurovascular structures and proposed a new segmental classification of extraorbital oculomotor nerve. Awareness of the endoscopic anatomy and the new segmental classification of the CN III may prove helpful in avoiding the risk of nerve injury during endoscopic endonasal surgery for skull base pathologies.
Topics: Cadaver; Cavernous Sinus; Endoscopy; Humans; Neurosurgical Procedures; Oculomotor Nerve; Skull Base
PubMed: 20012060
DOI: 10.1007/s00381-009-1051-z -
Neurosurgery Apr 2006To define the characteristics of the arachnoidal sleeve and cistern that accompany the oculomotor nerve through the cavernous sinus roof.
OBJECTIVE
To define the characteristics of the arachnoidal sleeve and cistern that accompany the oculomotor nerve through the cavernous sinus roof.
METHODS
Forty cavernous sinuses were examined using 3 to 40x magnification. Information was obtained about the size of the oculomotor cistern and its relationship to the roof of the cavernous sinus and anterior clinoid process.
RESULTS
An arachnoidal sleeve and cistern, referred to as the oculomotor cistern, accompanied the oculomotor nerve into the roof of all the cavernous sinuses examined. The oculomotor cistern extends from the oculomotor porus, where the nerve enters the roof of the cavernous sinus, to the area below the tip or the adjacent part of the lower margin of the anterior clinoid process. From the porus, the nerve passes forward and downward to the depth of the cistern where it becomes incorporated into the fibrous lateral wall of the cavernous sinus. The width of the cistern was maximal at the oculomotor porus averaged 5.5 mm (range, 3.0-9.2 mm), and tapered slightly towards the midpoint and deep end of the cistern. The cistern's average length was 6.5 mm (range, 3.0-11.0 mm). The oculomotor nerve usually coursed closer to the anterior than the posterior wall of the cistern at the level of the oculomotor porus.
CONCLUSION
The oculomotor cistern, an arachnoidal and dural cuff, accompanies the oculomotor nerve through the cavernous sinus roof to the area just below or anterior to the lower edge of the tip of the anterior clinoid process. The segment of the nerve inside the oculomotor cistern is interposed between its free portion in the interpeduncular cistern and the part of its course where it is incorporated into the fibrous lateral wall of the cavernous sinus. The cistern can be opened to aid in the exposure and mobilization of the nerve in dealing with pathology in the area.
Topics: Carotid Artery, Internal; Cavernous Sinus; Dissection; Dura Mater; Humans; Microsurgery; Oculomotor Nerve
PubMed: 16582644
DOI: 10.1227/01.NEU.0000204673.55834.BE -
Anatomical Science International Mar 2013Comprehension of the mesencephalic syndromes that affect oculomotor nerve fascicles requires a detailed knowledge of their relationship with the adjacent structures and...
Comprehension of the mesencephalic syndromes that affect oculomotor nerve fascicles requires a detailed knowledge of their relationship with the adjacent structures and the blood supply of the central midbrain region. This was the reasoning behind our study, which was performed in ten serially sectioned midbrains stained with cresyl violet and luxol fast blue, in three microdissected midbrains, and in two injected and cleared specimens. Three continuous groups of the intramesencephalic oculomotor nerve fascicles were distinguished: the caudal, intermediate and rostral. The caudal fascicles, which most likely innervate the superior rectus and the levator palpebrae superioris muscles, extend through the superior cerebellar peduncle just caudal to the red nucleus and close to the lateral lemniscus. The intermediate fascicles, devoted to the medial rectus and the inferior oblique muscles, always pass through the superior cerebellar peduncle, just medial to the caudal part of the red nucleus (60 %), and less frequently (40 %) through the nucleus itself. The rostral oculomotor fascicles, which terminate in the inferior rectus and sphincter pupillae muscles, course medial to the rostral part of the red nucleus. While the rostral and intermediate oculomotor fascicles are supplied only by the medial twigs of the paramedian mesencephalic perforating arteries, the caudal fascicles are also nourished by the lateral branches of the same perforating arteries. The data obtained form an important basis for the explanation of certain mesencephalic syndromes, and even anticipate some new syndromes not yet described in the literature.
Topics: Adult; Aged; Benzoxazines; Humans; Indoles; Mesencephalon; Microdissection; Middle Aged; Oculomotor Nerve
PubMed: 23242853
DOI: 10.1007/s12565-012-0166-6 -
Reviews of Oculomotor Research 1988The gross anatomy of the cerebellum is described along with different systems of regional nomenclature. The afferent and efferent connections of the flocculo-nodular... (Review)
Review
The gross anatomy of the cerebellum is described along with different systems of regional nomenclature. The afferent and efferent connections of the flocculo-nodular lobe, the uvula, paraflocculus, vermis and deep cerebellar nuclei are described in detail, and related to some aspects of oculomotor function.
Topics: Afferent Pathways; Animals; Cerebellum; Efferent Pathways; Eye Movements; Oculomotor Nerve; Terminology as Topic
PubMed: 3153648
DOI: No ID Found -
Investigative Ophthalmology & Visual... Jun 1986We studied the distribution of somatic motor neurons innervating the cat superior rectus 3-6 months after oculomotor nerve injury using intramuscular horseradish...
We studied the distribution of somatic motor neurons innervating the cat superior rectus 3-6 months after oculomotor nerve injury using intramuscular horseradish peroxidase (HRP). In normal cats, 98% or more of the labelled superior rectus motoneurons were in the contralateral oculomotor subnucleus. Two experimental cats who exhibited little or no evidence of recovery showed few labelled cells (4% of controls) which were distributed in both the ipsilateral and contralateral oculomotor nucleus. The other three experimental cats demonstrated definite signs of recovery, and HRP injections labelled more cells (20% of controls) also distributed in the ipsilateral and contralateral oculomotor subnuclei. This study shows that, after sectioning, the oculomotor nerve regenerates and anomalous connections develop between the somatic motoneurons of the ipsilateral oculomotor nucleus and the superior rectus. These findings support the hypothesis that acquired oculomotor synkinesis developing after third nerve injury results from misdirection of regenerating axons.
Topics: Animals; Biological Transport; Cats; Cell Count; Denervation; Horseradish Peroxidase; Nerve Regeneration; Oculomotor Nerve; Oculomotor Nerve Injuries; Peroxidases; Tissue Distribution
PubMed: 3710737
DOI: No ID Found