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20) Selective pupil sparing can, however, pose a diagnostic dilemma, because it can occur with subarachnoid compressions, particularly due to posterior communicating artery aneurysm, affecting the inferior part of the 3rd nerve, a site that does not initially impact the pupillo-motor fibres located at its superior or medial margin.
A follow-up angiogram on day 3 showed complete occlusion of the left carotid cavernous fistula with excellent crossfill at the anterior communicating artery and collateral flow to the left middle cerebral territory via the left posterior communicating artery (Fig 4).
When location was examined as a risk factor, only aneurysms in the anterior communicating artery (ACoA) and posterior communicating artery (PCoA) were significantly more likely to be found among patients with ruptured aneurysms.

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