Analysis of the recovery of third nerve function after direct surgical intervention for posterior communicating aneurysms

Abstract

Orthoptic analysis confirms that full recovery of a third nerve palsy associated with a posterior communicating aneurysm is possible but may take well over 2 yr. It occurred only if the aneurysm was treated by direct intracranial surgery within 10 days of the onset of the paresis. Those patients who did not recover completely and had been followed for over 3 yr all showed aberrant regeneration. The commonest single sign of this was adduction of the eye on attempted elevation (91%; the more classical pseudo Graefe sign occurred in only 27%).