Surgically created fourth-third cranial nerve communication: temporary success in a child with bilateral third nerve hamartomas. Case report.

• Shortly after birth, an otherwise healthy infant developed eye deviation and ptosis due to a hamartomatous lesion of the interpeduncular segment of the right oculomotor nerve. The left nerve became similarly involved when the child was 1.5 years of age. Direct nerve repair was not possible. Instead, the trochlear nerve was divided and its proximal end was attached to the distal end of the third nerve. Elevation of the upper eyelid and partial adduction of the eye developed gradually over the ensuing 3 to 5 months. Both functions were lost after an additional 2 months, presumably as a result of tumor recurrence or neuroma formation. This case report shows that surgically created fourth-third cranial nerve communication is feasible and may merit consideration under similar circumstances.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Oftalmologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Ophthalmology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Keyword

Anastomosis

Surgical

Cranial Nerve Diseases

complications

diagnosis

physiopathology

surgery

Hamartoma

complications

diagnosis

physiopathology

surgery

Humans

Infant

Magnetic Resonance Imaging

Male

Neoplasm Recurrence

Local

Neural Pathways

physiopathology

surgery

Oculomotor Nerve

surgery

Oculomotor Nerve Diseases

etiology

Time Factors

Trochlear Nerve

physiopathology

surgery

Publication and Content Type

ref (subject category)

art (subject category)