Orbital pain and unruptured carotid-posterior communicating artery aneurysms: the role of sensory fibers of the third cranial nerve.

Abstract:

:Intact aneurysms of the carotid siphon at the point of take-off of the posterior communicating artery may exhibit orbital pain, whether associated with oculomotor palsy or not as a warning symptom prior to rupture. In order to explain this symptom the hypothesis of a sensory pathway within the third cranial nerve, which is liable to compression by the enlarging aneurysm sac, has been investigated. Data from human autopsy material show evidence of sensory ganglion cells within the rootlets of the oculomotor nerve; furthermore, studies in animals prove that the third nerve contains sensory fibers which run proximally along the nerve bundles, enter the brainstem and reach the spinal trigeminal nucleus. These fibers come from the ophthalmic division of the fifth nerve and join the third nerve at the level of the lateral wall of the cavernous sinus. Although a number of questions remain to be solved, the presence of a sensory pattern within the third nerve could account for fronto-orbital pain from enlarging aneurysms impinging on the third nerve itself.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Lanzino G,Andreoli A,Tognetti F,Limoni P,Calbucci F,Bortolami R,Lucchi ML,Callegari E,Testa C

doi

10.1007/BF02001462

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

7-11

issue

1-2

eissn

0001-6268

issn

0942-0940

journal_volume

120

pub_type

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