Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

March 31, 2020; 94 (13) Resident & Fellow Section

Teaching NeuroImages: Pupil-sparing compression of oculomotor nerve by posterior cerebral artery vessel

Anfei Li, Anika Tandon, Apostolos J. Tsiouris, Marc J. Dinkin, Cristiano Oliveira
First published March 9, 2020, DOI: https://doi.org/10.1212/WNL.0000000000009181
Anfei Li
From the Division of Neuro-Ophthalmology (A.T., M.J.D., C.O.), Department of Ophthalmology, and Department of Radiology (A.J.T.), Weill Cornell Medicine (A.L.), New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anika Tandon
From the Division of Neuro-Ophthalmology (A.T., M.J.D., C.O.), Department of Ophthalmology, and Department of Radiology (A.J.T.), Weill Cornell Medicine (A.L.), New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Apostolos J. Tsiouris
From the Division of Neuro-Ophthalmology (A.T., M.J.D., C.O.), Department of Ophthalmology, and Department of Radiology (A.J.T.), Weill Cornell Medicine (A.L.), New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marc J. Dinkin
From the Division of Neuro-Ophthalmology (A.T., M.J.D., C.O.), Department of Ophthalmology, and Department of Radiology (A.J.T.), Weill Cornell Medicine (A.L.), New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cristiano Oliveira
From the Division of Neuro-Ophthalmology (A.T., M.J.D., C.O.), Department of Ophthalmology, and Department of Radiology (A.J.T.), Weill Cornell Medicine (A.L.), New York, NY.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Teaching NeuroImages: Pupil-sparing compression of oculomotor nerve by posterior cerebral artery vessel
Anfei Li, Anika Tandon, Apostolos J. Tsiouris, Marc J. Dinkin, Cristiano Oliveira
Neurology Mar 2020, 94 (13) e1450-e1451; DOI: 10.1212/WNL.0000000000009181

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
740

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

A 54-year-old woman presented with a 30-year history of worsening left blepharoptosis. Neuro-ophthalmic examination was significant for blepharoptosis, limited levator function, and supraduction in the left eye with left hypotropia, and normal pupils without diplopia. MRI brain/orbits revealed subtle atrophy of the left superior rectus (figure 1, A and B), without any orbital pathology. Superior compression of the left oculomotor nerve by the posterior cerebral artery (PCA) was observed (figure 1, C–E). Given the microanatomy of oculomotor nerve in the cistern space,1,2 this is a rare selective compression of the superolateral oculomotor nerve by the PCA vessel (figure 2), sparing the superomedial parasympathetic limb.

Figure 1
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1 Compression of the left CNIII nerve by left posterior cerebral artery

(A, B) Isolated asymmetric atrophy of the left superior rectus muscle (arrows). (C) Left posterior cerebral artery in cross-section (arrow) impinges upon the left CNIII (arrowhead). (D, E) Asymmetric flattening of the left CNIII (arrowheads) by the left posterior cerebral artery (arrows).

Figure 2
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 2 Illustration of the CNIII microanatomy (not to scale)

Image is constructed based on similar images in Brazis.3

Study funding

No targeted funding reported.

Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.

Appendix Authors

Table

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Teaching slides links.lww.com/WNL/B67

  • © 2020 American Academy of Neurology

References

  1. 1.↵
    1. Miyazaki S
    . Location of motoneurons in the oculomotor nucleus and the course of their axons in the oculomotor nerve. Brain Res 1985;348:57–63.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Atasever A,
    2. Durgun B,
    3. Celik HH,
    4. Yilmaz E
    . Somatotopic organization of the axons innervating the superior rectus muscle in the oculomotor nerve of the rat. Cells Tissues Organs 1993;146:251–254.
    OpenUrl
  3. 3.↵
    1. Brazis PW
    . Localization of lesions of the oculomotor nerve: recent concepts. Mayo Clin Proc 1991;66;1029–1035. Review.
    OpenUrlCrossRefPubMed

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Study funding
    • Disclosure
    • Appendix Authors
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study

Dr. Robert Shapiro and Dr. Amynah Pradhan

► Watch

Related Articles

  • Resident & Fellow Rounds

Topics Discussed

  • Ocular motility
  • MRI
  • Eyelids

Alert Me

  • Alert me when eletters are published
Neurology: 100 (5)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise