scholarly journals Effects of surgical clipping and endovascular embolization on the recovery of oculomotor nerve paralysis caused by posterior communicating artery aneurysm

2021 ◽  
Vol 26 (3) ◽  
pp. 471-478
Author(s):  
Kang Hu ◽  
Genping Cai ◽  
Liang Fu ◽  
Lili Huang ◽  
Wei Huang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Artery Aneurysm ◽  
Endovascular Embolization ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Therapeutic Effects ◽  
Partial Recovery ◽  
Surgical Clipping ◽  
Nerve Paralysis ◽  
Posterior Communicating Artery Aneurysm

Background and Objectives: Our study aimed to explore the therapeutic effects of surgical clipping and endovascular embolization on the recovery of oculomotor nerve paralysis (ONP) caused by posterior communicating artery aneurysm (PcomAA). Methods: The clinical data of patients with intracranial PcomAA and ONP were retrospectively analyzed. All patients were treated with surgical clipping or endovascular embolization, then followed up for no less than 12 months. Logistic regression analysis was performed to analyze the potential risk factors influencing ONP recovery. Results: Among 128 patients of ONP caused by PcomAA, 96 patients were treated with surgical clipping and 32 patients with endovascular embolization, respectively. Time from initial ONP onset to complete or partial recovery was 85.3 ± 36.8 days for patients receiving surgical clipping, and 135.7 ± 41.3 days for patients treated with endovascular embolization. The recovery rate was 94 (97.9%) in the surgical clipping group and 22 (68.8%) in the endovascular embolization group, and significant difference was shown between the two groups (P < 0.001). Logistic regression analyses demonstrated that the complete or partial recovery of ONP in the surgical clipping group was significantly better than that in the endovascular embolization group (OR, 5.582; 95%CI, 2.023-15.405; P <0.001). Moreover, time from initial symptom onset to receiving treatment also affect ONP recovery (OR, 0.893; 95% CI, 0.820-0.972; P = 0.009). Conclusion: Surgical clipping was superior to endovascular embolization in the recovery of ONP caused by PcomAA, and patients who received early intervention could result in better ONP recovery.

scholarly journals Recovery of posterior communicating artery aneurysm induced oculomotor nerve palsy: a comparison between surgical clipping and endovascular embolization

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Li-qiang Tian ◽  
Qing-xi Fu
Keyword(s):  
Nerve Palsy ◽  
Artery Aneurysm ◽  
Endovascular Embolization ◽  
Aneurysm Rupture ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Common Symptom ◽  
Surgical Clipping ◽  
Posterior Communicating Artery Aneurysm

Abstract Background Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysm (PcomAA) that can lead to impaired eye movement and pupil dilation. Currently, surgical clipping and endovascular embolization are the two most popular treatment methods for PcomAA-induced ONP; however, the recovery outcome between the two methods remains to be elucidated. Methods In the present study, we thoroughly compared the pretreatment factors and recovery outcome of the two treatments on 70 patients with PcomAA-induced ONP. The patients were separated into two groups based on the treatment that was received. Pretreatment factors, including age, sex, time period between ONP onset and treatment, ONP type, aneurysm diameter, status of subarachnoid hemorrhage and aneurysm rupture were recorded for each individual patient. Recovery outcome of the patients was assessed over a 12-month period. Results No significant differences were observed in any of the analyzed factors. Importantly, we revealed a significantly higher full recovery rate for the patients receiving the surgical clipping treatment than the ones that received the endovascular embolization treatment. In addition, we showed that patients’ age was negatively correlated with the recovery extent in both treatment groups. Conclusions The outcome of our study suggests that surgical clipping might be a better option to treat PcomAA-induced ONP.

Oculomotor Nerve Palsy Due To Posterior Communicating Artery Aneurysm: Clipping vs Coiling

2021 ◽  
Author(s):  
Alexandrina S. Nikova ◽  
Georgios S Sioutas ◽  
Katerina Sfyrlida ◽  
Grigorios Tripsianis ◽  
Michael Karanikas ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Oculomotor Nerve Palsy ◽  
Aneurysm Clipping ◽  
Posterior Communicating Artery Aneurysm

An Operative Complication in a Patient with a True Posterior Communicating Artery Aneurysm: Case report and Review of the Literature

Neurosurgery ◽  
1990 ◽  
Vol 27 (4) ◽  
pp. 650-653 ◽  
Author(s):  
Tadashi Kudo
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Review Of The Literature ◽  
Operative Complications ◽  
Posterior Communicating Artery Aneurysm ◽  
Aneurysmal Neck

Abstract Intraoperative oculomotor nerve injury in a patient with a true posterior communicating artery aneurysm is reported in detail. A comparison of internal carotid artery aneurysms at the posterior communicating artery junction with true posterior communicating artery aneurysms deserves special attention, because the vascular relationships of the aneurysm are more complex. A clip along the internal carotid artery does not occlude blood flow to the aneurysm, and the aneurysmal neck and the distal posterior communicating artery are closer to the oculomotor nerve. This is the 27th reported case of a true posterior communicating artery aneurysm. The incidence of true posterior communicating artery aneurysms ranges from 0.1 to 2.8% of all aneurysm patients. Such aneurysms constitute 4.6 and 11% of so-called posterior communicating aneurysms in two series. Difficulty associated with a preoperative diagnosis has been documented in at least 4 cases. An awareness of this rare aneurysm is stressed in order to avoid operative complications.

scholarly journals Unruptured internal carotid-posterior communicating artery aneurysm splitting the oculomotor nerve: A case report and literature review

2020 ◽  
Vol 11 ◽  
pp. 353
Author(s):  
Hirotaka Inoue ◽  
Akihito Hashiguchi ◽  
Koichi Moroki ◽  
Hajime Tokuda
Keyword(s):  
Internal Carotid ◽  
Artery Aneurysm ◽  
Underlying Mechanism ◽  
Nerve Fibers ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Age Related ◽  
Posterior Communicating Artery Aneurysm ◽  
Multiple Fibers ◽  
Loss Of Compactness

Background: Although it is well known that internal carotid-posterior communicating artery (ICA-PcomA) aneurysms compress the oculomotor nerve and cause nerve palsy, cases of ICA-PcomA aneurysms splitting the oculomotor nerve are extremely rare. Case Description: We present the rare case of an asymptomatic, growing, left-sided ICA-PcomA aneurysm that was confirmed to split the oculomotor nerve. We report the clinical course and discuss the underlying mechanism. The oculomotor nerve, which is an aggregate of multiple fibers, exhibits age-related loss of compactness in the arrangement of its nerve fibers. Conclusion: We speculate that injury to the nerve fibers by aneurysmal compression was avoided because of the rare phenomenon of splitting of the oculomotor nerve.

Cavernous Malformation of the Oculomotor Nerve Mimicking a Partially Thrombosed Posterior Communicating Artery Aneurysm: Report of Two Cases

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. E470-E474 ◽  
Author(s):  
Stacey Quintero Wolfe ◽  
Glen Manzano ◽  
David J. Langer ◽  
Jacques J. Morcos
Keyword(s):  
Magnetic Resonance ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Artery Aneurysm ◽  
Oculomotor Nerve ◽  
Posterior Communicating Artery ◽  
Radiographic Appearance ◽  
Cavernous Malformations ◽  
Cranial Nerve Function ◽  
Posterior Communicating Artery Aneurysm

Abstract BACKGROUND AND IMPORTANCE: Cavernous malformations of the cranial nerves are exceedingly rare. The classic radiographic appearance of cavernous malformations may not be obvious when located in a cranial nerve. CLINICAL PRESENTATION: We present 2 cases of acute oculomotor paresis caused by cavernous malformations of the oculomotor nerve that were mistaken for a thrombosed posterior communicating artery aneurysm on magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography. Both patients underwent a craniotomy with exploration of the lesion. Both cavernous malformations were completely resected while the integrity of the third cranial nerve was maintained. One patient experienced complete resolution of the oculomotor palsy. CONCLUSION: Although rare, cavernous malformations should be included in the differential diagnosis of a partially thrombosed posterior communicating artery aneurysm. Exploration and complete lesional resection are possible with improvement of the cranial nerve function.

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