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At least 19 recordsLinked to original sources
PubMed1988

The central-peripheral transitional regions of cranial nerves. Oculomotor nerve.

Oculomotor nerve rootlets varied more markedly in size and in transitional zone length and form than those of any other nerve studied to date. However, they could be classified into four main types, each of which was associated with a characteristic type of central-peripheral transitional zone. Type 1 rootlets emerged from the brainstem through a tongue-shaped elevation of the glia limitans. This type of central-peripheral transition is found elsewhere only in a minority of abducent rootlets (Fraher et al. 1988). Type 2 rootlets contained long segments made up entirely of central nervous tissue and were the only motor rootlets so far described to contain a segment of this kind. Type 3 rootlets were the commonest and the largest. Before leaving the brainstem they ran laterally on its surface as the emergent rootlet segments, forming plexuses with one another. These rootlets contained a unique wedge-shaped type of central tissue projection. Over its entire length one surface of this coincided with the rootlet surface and a thin tapering strip of peripheral nervous tissue extended proximally for a considerable distance into the emergent rootlet segment. Type 4 rootlets emerged from the brainstem surface obliquely and contained a glial fringe.

Animals↗
PubMed1998

Synkinesis between facial nerve and oculomotor nerve. A case report.

We present a case history of a young man suffering from a facial-oculomotor synkinesis. The findings speak in favour of an acquired synkinesis due to trauma. Most probably the injury occurred in the midbrain, in the area of the vertical gaze control center and/or the area of the levator palpebrae motoneurons. A congenital synkinesis due to embryonic malformation seems to be unlikely, because at birth no restriction of the eye-ball motility was present.

Accidents, Traffic↗
PubMed1999

En bloc resection of an intracavernous oculomotor nerve schwannoma and grafting of the oculomotor nerve with sural nerve. Case report and review of the literature.

A case in which a left oculomotor nerve schwannoma treated by en bloc resection of the lesion and grafting of the oculomotor nerve with sural nerve is presented. Recovery of nerve function was partial, but useful and cosmetically good. The last follow-up examination performed 2 years after surgery revealed recovery of function in the elevator muscle of the upper eyelid, together with slight vertical movement of the eye.

Cavernous Sinus↗
PubMed2004

Histopathologic changes in oculomotor nerve and ciliary ganglion in aneurysmatic compression injuries of oculomotor nerve.

BACKGROUND: Bilateral common carotid artery ligation (BCCAL) increases vertebrobasilar blood flow and leads to increased luminal pressure, luminal enlargement, wall thinning, convolutions and sometimes aneurysm formation in posterior circulation arteries, especially the posterior communicating arteries (PcomA). PcomA aneurysms compress the oculomotor nerves. The principal aim of this investigation is to examine the histopathologic results of the compressive effect of PcomA aneurysms on the oculomotor nerves (OMN) and on ciliary ganglions (CG). METHODS: When we observed the effects of BCCAL on the posterior circulation arteries of the brain in fifteen ligated rabbits after sacrifice, we noticed aneurysm formation on these arteries in three rabbits. These aneurysms developed on the PcomAs compressed the oculomotor nerves. These compressed nerves and normal oculomotor nerves together with their ciliary ganglions were examined histopathologically. RESULTS: A PComA aneurysm developed in three rabbits from 15 ligated animals and these aneurysms compressed the oculomotor nerves on the same side. Partial peripheral necrosis and axonal loss were seen on the compressed oculomotor nerves. Concomitantly, cellular loss and necrosis were also observed on their ganglions. CONCLUSION: Bilateral common carotid artery ligation may lead to PcomAs and these aneurysms could compress the oculomotor nerves. Compression injuries of oculomotor nerve may cause cellular injury and necrosis on both oculomotor nerves and ciliary ganglions.

Animals↗
PubMed2003

Oculomotor nerve schwannoma.

Oculomotor nerve schwannoma is an extremely rare tumour. Only 26 sufficiently described cases of oculomotor nerve schwannomas were found in the literature. The case of an oculomotor nerve schwannoma in a 12-year-old girl is presented. Clinical manifestations, as well as the aim for the radical resection with oculomotor function preservation are reviewed.

Child↗
PubMed2000

Unmyelinated nerve fiber analysis of the human oculomotor nerve.

Unmyelinated nerve fibers of the oculomotor nerve have occasionally been observed in experimental animals with the use of electron microscopes, but no details concerning normal oculomotor nerves in humans have been published. We measured and analyzed unmyelinated nerve fibers in the human oculomotor nerve with an image analyzer and a computer, using a new staining method, the Luxol fast blue-periodic acid-Schiff-hematoxylin (LPH) discriminative staining method which is the only one suitable for morphometric research on nervous tissues. We studied the numbers and transverse areas of unmyelinated fibers of the oculomotor nerve in 20 cadavers. The number of unmyelinated axons did not change with age, but the mean transverse area decreased with age. These fibers were distributed diffusely in the transverse area of the oculomotor nerve, not localized in any part of the nerve. These findings may be important for the analysis of clinical and neurological signs in relation to aging and ophthalmologic functions.

Adult↗
PubMed1999

End-to-end versus peripheral nerve graft repair of the oculomotor nerve in rats: A comparative histological and morphometric study.

A comparative study was undertaken to evaluate end-to-end versus peripheral nerve graft repair in cranial nerve reconstruction. In 14 rats, the oculomotor nerve was sharply transected in the cavernous sinus and repaired either by end-to-end coaptation (n = 7) or by interposition of a peripheral nerve graft (n = 7). The results were evaluated 16 weeks after surgery by light and transmission electron microsurgery and by morphometric analysis. The degree of neuroma formation, fibrosis, and axonal disorganisation at the repair site was the same for both groups. Histologically, both end-to-end and graft repair groups revealed various degrees of axonal regeneration with myelinated nerve fibres in the distal nerve segments. In both groups, the number of nerve fibres distal to the repair site was increased compared to proximal to the repair (P < 0.001) but myelinated axon diameter was significantly less than that of control nerves (P < 0.001). No difference existed between the two repair groups in terms of mean myelinated axonal diameter. However, the number and density of myelinated axons was statistically greater in the graft group (P < 0.05). In conclusion, despite the disadvantage of two repair sites, peripheral nerve grafting results in equal or slightly superior axonal regeneration compared to an end-to-end repair in the rodent model of intracranial oculomotor nerve reconstruction. We speculate that this may be due to the structure of the peripheral nerve graft.

Animals↗
PubMed2006

Traumatic oculomotor nerve palsy.

Traumatic isolated oculomotor nerve palsy is not common. Oculomotor nerve palsy without internal ophthalmoplegia (pupil sparing) is extremely rare. We report a case of this condition in a child. An 11-year-old boy was transferred to our hospital after a head injury in a traffic accident. Neuro-ophthalmic examination showed that the left eye had limited adduction, supraduction, and infraduction, incomplete convergence and left ptosis, but no internal ophthalmoplegia. Magnetic resonance imaging indicated mild bending of the ipsilateral oculomotor nerve at the posterior petroclinoid ligament. One month after injury, movement of the patient's eyes was normal on examination, but there was mild diplopia. The suggested mechanism of the oculomotor nerve palsy with pupil sparing in this case is stretching of the oculomotor nerve at the posterior petroclinoid ligament, maintaining an intact pupillomotor nerve.

Brain Injuries↗
PubMed2003

A neuro-Behcet's lesion in oculomotor nerve nucleus.

OBJECTIVE: Fascicular oculomotor nerve involvement is occasionally seen in Behcet's disease, but nuclear involvement is very rare. CASE PRESENTATION: A 25-year-old woman presented with the Behcet's symptoms and the left eye problems. Physical examination revealed muco-cutaneous lesions, eyelid ptosis, mydriasis, upward and medial gaze palsy and lateral deviation on the left eye. Serologic tests were positive. An inflammatory lesion was detected in the left oculomotor nerve nucleus on magnetic resonance imaging. Neuro-Behcet's disease was considered the most likely diagnosis. RESULT: Dexamethasone treatment was ordered. Muco-cutaneal lesions, laboratory abnormalities were normalized after 1 year; but oculomotor nerve palsy persisted in spite of improvement in radiological findings. CONCLUSION: Clinical signs of oculomotor nerve palsy may persist despite the radiological improvement.

Adult↗
PubMed2006

Malignant peripheral nerve sheath tumor of the oculomotor nerve.

We present the short-term follow-up magnetic resonance (MR) studies and 1H-MR spectroscopy in a child with malignant peripheral nerve sheath tumor of the oculomotor nerve associated with other less aggressive cranial nerve schwannomas. The tumor revealed perineural extension and diffuse nerve involvement besides rapid growth. 1H-MR spectroscopy was helpful in excluding an intra-axial neoplasm with exophytic growth, mainly due to the absence of creatine and N-acetyl aspartate peaks, and markedly elevated choline peak.

Aspartic Acid↗
PubMed1991

Localization of lesions of the oculomotor nerve: recent concepts.

The anatomic features of the third cranial nerve (the oculomotor nerve) and the localization of lesions that affect it are reviewed. Recent considerations of the organization of the oculomotor fascicles in the ventral mesencephalon, the superior and inferior divisional palsies localized proximal to the cavernous sinus, and the possibility of the localization of ischemic oculomotor palsies to the mesencephalon rather than a peripheral site are emphasized. The characteristic manifestations of nuclear lesions (unilateral palsy of the third cranial nerve, weakness of the ipsilateral and contralateral superior rectus muscles, and bilateral incomplete ptosis) are described, as are other variations of nuclear involvement. Although proptosis is typically associated with orbital masses, it may also result from lesions of the cavernous sinus or (rarely) an intracranial lesion. Metastatic orbital tumors often are the first evidence of systemic spread in patients with cancer; infiltrative and mass lesions are the most common. Aberrant regeneration of the oculomotor nerve may occur months to years after the occurrence of an oculomotor lesion.

Cranial Nerve Diseases↗
PubMed1985

Location of motoneurons in the oculomotor nucleus and the course of their axons in the oculomotor nerve.

Subdivisions of the oculomotor nucleus, and the course of axons in the brainstem and more peripherally in the oculomotor nerve of the cat, were studied by directly applying horseradish peroxidase solution to the transected nerve-branch stump in the orbit. The medial rectus subdivision consisted of two subgroups, and intermingling between subdivisions was found. About 20% of the motoneurons controlling the medial rectus muscle were scattered in the medial longitudinal fasciculus or a more ventrolateral area. A few motoneurons controlling the inferior rectus or inferior oblique muscle were also located in the medial longitudinal fasciculus. Axons to the superior branch that supplied the superior rectus and levator muscle coursed in the dorsolateral half of the oculomotor nerve. In contrast, those to the medial rectus, inferior rectus, and inferior oblique muscles were scattered diffusely in the oculomotor nerve.

Animals↗
PubMed1996

Primary glioblastoma multiforme of the oculomotor nerve. Case report.

Tumors of the oculomotor nerve are rare and most instances reported have been schwannomas. The authors present clinical, neuroradiological, and neuropathological findings in a 70-year-old woman with a glioblastoma multiforme (GBM) growing primarily in the proximal part of the left oculomotor nerve. The patient presented with a 1-month history of transient diplopia. Neurological examination revealed an incomplete left-sided oculomotor nerve palsy with no further signs of neurological dysfunction. Cranial computerized tomography and magnetic resonance imaging showed a tumor of the left oculomotor nerve without any obvious signs of penetration into the midbrain or upper pons. Following subtotal removal of the tumor, neuropathological examination of the operative specimen revealed a GBM that had grown diffusely within peripheral nerve tissue. Six weeks after surgery, the patient suddenly died of pulmonary thromboembolism. Postmortem examination of the brain confirmed a large leptomeningeal GBM at the left pontomesencephalic junction with complete destruction of the left oculomotor nerve. To the authors' knowledge, this represents the first case of a GBM of the oculomotor nerve, probably originating from glial cells within the most proximal part of the nerve or the adjacent leptomeninges.

Aged↗
PubMed2003

Reinnervation of extraocular muscles by facial-to-oculomotor nerve anastomosis in rats: anatomic nuclear changes.

OBJECTIVE: Oculomotor nerve palsy greatly impairs the patient's daily life. After oculomotor nerve injury, when the central nerve stump is not available, neurotization of the distal nerve stump with a donor nerve may be performed. Here, we present an experimental anatomic study in rats related to the motor nuclear organization after facial-to-oculomotor nerve anastomosis. METHODS: In adult rats, the right oculomotor nerve was transected at the skull base. Then, the ipsilateral facial nerve was exposed at the stylomastoid foramen and connected side-to-end to one extremity of a peroneal nerve autograft. The other extremity of the nerve autograft was connected end-to-end to the distal stump of the transected oculomotor nerve. Twelve weeks later, axonal regeneration in the autograft and brainstem somatotopic representation of the reinnervated extraocular muscles were investigated by use of histological and retrograde axonal tracing techniques. RESULTS: The autograft was reinnervated by a large number of small axons, 1 to 5 microm in diameter. After tracer injection into the superior rectus and medial rectus muscles, retrogradely labeled neurons were seen not only in the ipsilateral facial nucleus (16%) but also in the contralateral nucleus (8%). Labeled neurons were also seen in the ipsilateral abducens (12%), motor trigeminus (7%), trochlear (23%), and contralateral trochlear (34%) nuclei. In normal rats, the extraocular muscles are innervated by unilateral-ipsilateral brainstem motor nuclei, except for the superior rectus and superior oblique muscles, which are innervated by bilateral, primarily contralateral, nuclei. CONCLUSION: The central rearrangement of the extraocular muscle nuclei after facial-to-oculomotor nerve anastomosis represents an original example of plasticity. Functional studies are needed to demonstrate whether this procedure might serve to restore some degree of eye motility.

Anastomosis, Surgical↗
PubMed2001

Hemorrhage in the oculomotor nerve as a complication of leukemia.

Oculomotor paralysis of a patient with leukemia was revealed at autopsy to be caused by a hemorrhage in the oculomotor nerve. In a 63-year-old woman with pre-B-cell acute lymphatic leukemia, leukemic invasions occurred in her spinal cord and right oculomotor nerve during a hematological remission state. The oculomotor palsy was aggravated to complete paralysis during a leukemic relapse, which lasted until her death. An autopsy revealed a hemorrhage along with leukemic cells in the right oculomotor nerve at the segment in the upper orbital fissure. Although hemorrhagic oculomotor paralysis is a very rare complication, reports of its occurrence will likely increase with improved survival times of leukemia patients due to advances in chemotherapy.

Acute Disease↗
PubMed2006

Oculomotor nerve schwannoma located in the oculomotor cistern.

BACKGROUND: OSs are extremely rare tumors, most often located in the interpeduncular cistern or the CS. We report an OS located predominantly within the oculomotor cistern, the arachnoid sac that surrounds the nerve for a short distance in the roof of the CS. We discuss a possible growth pattern for cavernous OSs. CASE DESCRIPTION: We report the case of a 34-year-old woman presenting with a right oculomotor nerve palsy. Magnetic resonance imaging revealed a mass within the borders of the roof of the CS extending forward toward the superior orbital fissure. A right pterional approach was undertaken, and the roof of the CS was opened just above the oculomotor nerve toward the superior orbital fissure. Although the part of the OS inside the oculomotor cistern was excised completely while preserving the anatomical continuity of the nerve, a subtotal removal was performed for the more anterior part of the tumor toward the superior orbital fissure. At 5 months follow-up, her third nerve paresis had improved dramatically. CONCLUSIONS: Resection of cavernous OSs within the oculomotor cistern, where the third nerve is clearly separated from the adjacent neurovascular structures, is feasible with functional preservation of the nerve. The chance of occurrence of the nerve palsy may increase as the resection proceeds more anteriorly toward the superior orbital fissure.

Adult↗