Abstract
RATIONALE: The purpose of this case report is to describe the process of oculomotor nerve palsy (ONP) in a patient after interventional treatment of anterior communicating artery aneurysms, so as to remind clinicians to pay attention to the condition of ONP in such patients. PATIENT CONCERNS: A 73-year-old female patient was admitted with spontaneous vomiting for 4 days and had a Glasgow coma score score of 12 after admission. Three hours after admission, the Glasgow coma score score decreased to 5, and subsequent lumbar puncture drainage revealed bloody CSF. DIAGNOSES: Cerebral angiography confirmed the presence of 2 anterior communicating aneurysms. INTERVENTIONS: Stent-assisted coil embolization (stent model: LVIS3.5-17, coil model: APB-1.5-3-3D, APB-1-2-3D, APB-1-1-HX) was performed. A stent was placed in the A2 segment of the anterior cerebral artery, and the aneurysm was completely embolized by stent-assisted release of 3 coils. OUTCOMES: The patient developed persistent unilateral ONP after surgery and was not followed up because the family requested discharge. LESSONS: Anterior communicating artery aneurysms are often mistakenly thought not to cause ONP due to their anatomical relationship. Our case confirms that in rare cases, ACOA aneurysm can also cause ONP, which reminds clinicians that they should think more comprehensively when patients present with ONP.