Fenestrated Oculomotor Nerve Caused by Internal Carotid-Posterior Communicating Artery Aneurysm: Case Report

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Abstract
The fenestrated oculomotor nerve associated with the internal carotid-posterior communicating artery aneurysm is very rare. A 48-year-old woman had a history of subarachnoid hemorrhage caused by a ruptured right middle cerebral artery aneurysm, which was wrapped with good postoperative course. Twenty years later, the patient suffered frontal headache with a mild oculomotor nerve paresis in the right side. Follow-up neuroimaging studies demonstrated a de novo right internal carotid-posterior communicating artery aneurysm. The aneurysm was exposed and clipped via a right pterional route. The fenestrated oculomotor nerve associated with the aneurysm was confirmed at surgery. We speculated that the fenestration was most likely caused, by the growth of the aneurysm.

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