scholarly journals Outcomes of Oculomotor Nerve Palsy Caused by Internal Carotid Artery Aneurysm: Comparison between Microsurgical Clipping and Endovascular Coiling

2015 ◽  
Vol 55 (12) ◽  
pp. 885-890 ◽  
Author(s):  
Masaki MINO ◽  
Masahiro YOSHIDA ◽  
Takahiro MORITA ◽  
Teiji TOMINAGA
Keyword(s):  
Carotid Artery ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Endovascular Coiling ◽  
Carotid Artery Aneurysm ◽  
Microsurgical Clipping ◽  
Internal Carotid Artery Aneurysm

scholarly journals Persistent hyperprolactinemia, transient hypopituitarism, and transient contralateral third nerve palsy after endovascular treatment of an internal carotid artery aneurysm: Case report and review of the literature

2020 ◽  
Vol 8 ◽  
pp. 2050313X2094871
Author(s):  
Tim Wende ◽  
Gordian Hamerla ◽  
Ulf Quäschling ◽  
Amelie Haase ◽  
Jürgen Meixensberger ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysms ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Third Nerve Palsy ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm

Intracranial aneurysms have an estimated prevalence of about 3%. A rare subgroup are aneurysms of the internal carotid artery that develop medially into the sellar region. Due to the risk of rupture with subsequent subarachnoid hemorrhage and of compression of surrounding structures, mechanical occlusion is advised. Hypopituitarism is not a rare disease and most often related to pituitary adenoma. Only 0.17% of cases with hypopituitarism are caused by unruptured intracranial aneurysms. Today, the predominant treatment of these aneurysms is endovascular coiling or application of flow diverting stents. We present the case of a 60-year-old female patient, who was treated with endovascular coiling for a right-sided, intracavernous, incidental internal carotid artery aneurysm. On postinterventional day 6, she was readmitted with contralateral third nerve palsy, mild hyponatremia und thyreotropic insufficiency. The symptoms recovered after anti-edematous treatment with corticosteroids; only an asymptomatic hyperprolactinemia persisted. To the best of our knowledge, this is the first case report of transient contralateral cranial nerve palsy combined with transient hypopituitarism after endovascular treatment of an internal carotid aneurysm. As treatment we propose corticosteroids, if necessary in combination with nonsteroidal anti-inflammatory drugs, in order to inhibit inflammatory reactions of the aneurysm wall compromising the nearby, partially compressed neural structures.

scholarly journals Evaluation of Surgical Clipping and Endovascular Coiling on Oculomotor Nerve Palsy Caused by Internal Carotid Artery Aneurysm

2020 ◽  
Vol 11 ◽  
Author(s):  
Zhenqing Sun ◽  
Xueqiang Yan ◽  
Xiaolong Li ◽  
Jie Wu
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Recovery Rate ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Endovascular Coiling ◽  
Surgical Clipping ◽  
Microsurgical Clipping

Objectives: Internal carotid artery (ICA) aneurysm often leads to oculomotor nerve palsy (ONP) that impairs eye movement. Currently, microsurgical clipping and endovascular coiling are the two major options to treat ONP. The purpose of the current study is to compare the clinical outcomes of the two methods in patients with ONP caused by ICA aneurysm.Patients and Methods: In the present study, we assessed the prognostic factors and recovery outcomes of a total of 90 ICA aneurysm-induced ONP patients, where 50 of them were treated with microsurgical clipping and 40 of them were treated with endovascular coiling. Within the endovascular coiling group, 20 of the patients were treated with balloon-assisted coiling and the other 20 were treated with stent-assisted coiling.Results: Overall, we achieved a 59% (53 out of 90) full recovery rate. Both surgical clipping and endovascular coiling treatment methods achieved similar recovery outcomes in the tested patients. However, within the endovascular coiling group, balloon-assisted coiling treatment demonstrated a significantly higher full recovery rate (17 out of 20) compared to stent-assisted coiling treatment (eight out of 20).Conclusion: In general, no significant difference was identified between the surgical and coiling treatments, and both procedures were considered as beneficial for ICA aneurysm-induced ONP.

scholarly journals Intracavernous Internal Carotid Artery Aneurysm Presenting as Acute Diplopia: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 362-365
Author(s):  
Austin Brown ◽  
Health Jolliff ◽  
Douglas Poe ◽  
Michael Weinstock
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Sixth Nerve

Introduction: Diplopia is an uncommon emergency department (ED) complaint representing only 0.1% of visits, but it has a large differential. One cause is a cranial nerve palsy, which may be from a benign or life-threatening process. Case Report: A 69-year-old female presented to the ED with two days of diplopia and dizziness. The physical exam revealed a sixth cranial nerve palsy isolated to the left eye. Imaging demonstrated an intracavernous internal carotid artery aneurysm. The patient was treated with embolization by neurointerventional radiology. Discussion: The evaluation of diplopia is initially divided into monocular, usually from a lens problem, or binocular, indicating an extraocular process. Microangiopathic disease is the most common cause of sixth nerve palsy; however, more serious etiologies may be present, such as an intracavernous internal carotid artery aneurysm, as in the patient described. Imaging modalities may include computed tomography or magnetic resonance imaging. Conclusion: Some causes of sixth nerve palsy are benign, while others will require more urgent attention, such as consideration of an intracavernous internal carotid artery aneurysm.

scholarly journals Staged Multimodality Treatment of a Large Ruptured Fusiform Supraclinoid Internal Carotid Artery Aneurysm: Microsurgical Clip.assisted Endovascular Coiling

2017 ◽  
Vol 08 (04) ◽  
pp. 668-671 ◽  
Author(s):  
Dale Ding ◽  
Thomas J. Buell ◽  
Ching-Jen Chen ◽  
Daniel M. Raper ◽  
Kenneth C. Liu ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Multimodality Treatment ◽  
Endovascular Coiling ◽  
Fusiform Aneurysm ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Supraclinoid Internal Carotid Artery

ABSTRACTIn the contemporary era of aneurysm management, large fusiform aneurysms presenting with subarachnoid hemorrhage (SAH) remain particularly challenging lesions to successfully manage. We describe a staged, multimodal treatment strategy for a 71-year-old patient who presented with a large ruptured fusiform aneurysm of the supraclinoid internal carotid artery (ICA) and a fetal posterior communicating artery which originated from the inferomedial aspect of the aneurysm. In the first stage, we performed a partial microsurgical clip reconstruction of the fusiform aneurysm and secured its rupture site, which was identified intraoperatively. This left two residual saccular components of the aneurysm, which were targeted with endovascular coiling in the same hospitalization after the patient had convalesced from the SAH and was beyond the vasospasm window. We believe that this combined approach of clip-assisted coiling can be employed instead of endovascular flow diversion or microsurgical bypass for appropriately selected patients with ruptured fusiform ICA aneurysms.

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