Acta Neurochirurgica

, Volume 120, Issue 1, pp 7–11

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

Authors

  • G. Lanzino
    • First Division of NeurosurgeryBellaria Hospital
  • A. Andreoli
    • First Division of NeurosurgeryBellaria Hospital
  • F. Tognetti
    • First Division of NeurosurgeryBellaria Hospital
  • P. Limoni
    • First Division of NeurosurgeryBellaria Hospital
  • F. Calbucci
    • First Division of NeurosurgeryBellaria Hospital
  • R. Bortolami
    • First Division of NeurosurgeryBellaria Hospital
  • M. L. Lucchi
    • First Division of NeurosurgeryBellaria Hospital
    • Institute of Veterinary AnatomyUniversity of Bologna
  • E. Callegari
    • First Division of NeurosurgeryBellaria Hospital
    • Institute of Veterinary AnatomyUniversity of Bologna
  • C. Testa
    • First Division of NeurosurgeryBellaria Hospital
Clinical Articles

DOI: 10.1007/BF02001462

Cite this article as:
Lanzino, G., Andreoli, A., Tognetti, F. et al. Acta neurochir (1993) 120: 7. doi:10.1007/BF02001462

Summary

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 frontoorbital pain from enlarging aneurysms impinging on the third nerve itself.

Keywords

Oculomotor nervetrigeminal nerveintracranial aneurysmorbital pain

Copyright information

© Springer-Verlag 1993