Abnormal Course of the Oculomotor Nerve on the Clivus Combined with a Petroclival Meningioma: Case Report

Masateru Katayama; Takeshi Kawase; Shuzo Sato; Atsuhiro Kojima; Kazunari Yoshida

doi:10.1055/s-2002-33460

Skull Base, Table of Contents

Skull Base 2002; 12(3): 141-144
DOI: 10.1055/s-2002-33460

CASE REPORT

Abnormal Course of the Oculomotor Nerve on the Clivus Combined with a Petroclival Meningioma: Case Report

Masateru Katayama¹ , Takeshi Kawase¹ , Shuzo Sato¹ , Atsuhiro Kojima¹ , Kazunari Yoshida¹

¹Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan

Abstract

ABSTRACT

The course of the oculomotor nerve on the clivus was abnormal in a patient with petroclival meningioma. He complained of gait disturbance. A gadolinium-enhanced magnetic resonance image demonstrated a 4.4-cm enhancing mass in the petroclival region. The tumor was removed via an anterior transpetrosal-transtentorial approach. Normally, the oculomotor nerve originates from the brainstem and enters the oculomotor trigone. In this patient, the oculomotor nerve entered the dura mater at the upper clivus, behind the posterior clinoid process, and coursed parallel to the basilar artery. This entrance is lower than the normal entry point of the oculomotor nerve. The abnormal entrance of the oculomotor nerve may reflect an atypical developmental relationship among the cranial nerves, meninges, and bones during embryogenesis.

KEYWORDS

Petroclival meningioma - anatomical variation - oculomotor nerve - microanatomy - anterior transpetrosal-transtentorial approach

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References

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