A case of delayed contralateral oculomotor nerve palsy after microsurgical clipping of a posterior communicating artery aneurysm

Delayed postoperative oculomotor nerve palsy is a rare complication that occurs in the setting of microsurgical aneurysm clipping. While a number of theories have been postulated to explain the development of delayed postoperative oculomotor nerve palsies, the underlying pathophysiology of such complications still remain to be elucidated. In this report, we present a case of delayed postoperative isolated contralateral oculomotor nerve palsy after clipping of a posterior communicating artery aneurysm, which we believe may be attributed to lumbar over drainage. With timely and appropriate management, complete neurologic recovery was achieved.