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

Others have reported improvement after carotid ligation. Hamilton and Falconer (I 959) found that all third nerve palsies improved with surgery, although they state that slight persisting weakness of the extraocular muscles was not assessed. Cantu (I 969) graded the amount of third nerve recovery after carotid ligation. Grades I and II were regarded as satisfactory while III and IV were unsatisfactory. Grade I included those with slight pupillary abnormality or a restriction of less than 30 per cent. in the functional amplitude of any muscle; Grade II could include diplopia in upward gaze, intermittent horizontal diplopia, ptosis of small degree, or minor examples of aberrant regeneration (such as the pseudoGraefe sign). He stated: