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Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience

INTRODUCTION: Surgical oculomotor nerve palsy(ONP), defined by ptosis, ophthalmoplegia, diplopia and pupillary dilatation, is associated with intracranial aneurysms, especially posterior communicating artery (PcomA) aneurysms. Treatment of PcomA aneurysms include endovascular coiling and surgical cl...

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Autores principales: Mak, Siu Kei David, Qiu, Liming, Ng, Yew Poh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159044/
https://www.ncbi.nlm.nih.gov/pubmed/30283504
http://dx.doi.org/10.4103/1793-5482.238085
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author Mak, Siu Kei David
Qiu, Liming
Ng, Yew Poh
author_facet Mak, Siu Kei David
Qiu, Liming
Ng, Yew Poh
author_sort Mak, Siu Kei David
collection PubMed
description INTRODUCTION: Surgical oculomotor nerve palsy(ONP), defined by ptosis, ophthalmoplegia, diplopia and pupillary dilatation, is associated with intracranial aneurysms, especially posterior communicating artery (PcomA) aneurysms. Treatment of PcomA aneurysms include endovascular coiling and surgical clipping. This study retrospectively compared the recovery of ONP in patients who underwent endovascular coiling or surgical clipping. METHODS: A retrospective review of patients with PcomA aneurysms who presented with ONP between 1998 and 2012 in the National Neuroscience Institute, Singapore, was performed. Inclusion criteria included adult patients of age above 21 who have radiologically confirmed PcomA aneurysms with presentation of ipsilateral ONP. The aneurysms may be unruptured or ruptured with WFNS grade 2 subarachnoid hemorrhage (SAH) or better. Only patients with completely surgically or endovascularly obliterated PcomA aneurysms with regular follow-up are included. RESULTS: A total of 22 patients were recruited. They were treated by either endovascular coiling or surgical clipping. The two groups of patients were demographically comparable, with 11 patients in each arm. 13 (59%) patients had unruptured aneurysms and 9 (41%) had WFNS grade 2 or better SAH. 13 (59%) patients presented with complete ONP and 9 (41%) had partial ONP. 64% of patients who underwent surgical clipping had resolution of ONP completely, compared to 18% of endovascularly coiling (P = 0.03) at 1-month follow-up. CONCLUSION: Compared to endovascular coiling, surgically clipped PcomA aneurysms are associated with a faster rate of full recovery of ONP.
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spelling pubmed-61590442018-10-03 Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience Mak, Siu Kei David Qiu, Liming Ng, Yew Poh Asian J Neurosurg Original Article INTRODUCTION: Surgical oculomotor nerve palsy(ONP), defined by ptosis, ophthalmoplegia, diplopia and pupillary dilatation, is associated with intracranial aneurysms, especially posterior communicating artery (PcomA) aneurysms. Treatment of PcomA aneurysms include endovascular coiling and surgical clipping. This study retrospectively compared the recovery of ONP in patients who underwent endovascular coiling or surgical clipping. METHODS: A retrospective review of patients with PcomA aneurysms who presented with ONP between 1998 and 2012 in the National Neuroscience Institute, Singapore, was performed. Inclusion criteria included adult patients of age above 21 who have radiologically confirmed PcomA aneurysms with presentation of ipsilateral ONP. The aneurysms may be unruptured or ruptured with WFNS grade 2 subarachnoid hemorrhage (SAH) or better. Only patients with completely surgically or endovascularly obliterated PcomA aneurysms with regular follow-up are included. RESULTS: A total of 22 patients were recruited. They were treated by either endovascular coiling or surgical clipping. The two groups of patients were demographically comparable, with 11 patients in each arm. 13 (59%) patients had unruptured aneurysms and 9 (41%) had WFNS grade 2 or better SAH. 13 (59%) patients presented with complete ONP and 9 (41%) had partial ONP. 64% of patients who underwent surgical clipping had resolution of ONP completely, compared to 18% of endovascularly coiling (P = 0.03) at 1-month follow-up. CONCLUSION: Compared to endovascular coiling, surgically clipped PcomA aneurysms are associated with a faster rate of full recovery of ONP. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6159044/ /pubmed/30283504 http://dx.doi.org/10.4103/1793-5482.238085 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mak, Siu Kei David
Qiu, Liming
Ng, Yew Poh
Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title_full Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title_fullStr Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title_full_unstemmed Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title_short Recovery of Oculomotor Nerve Palsy after Endovascular and Surgical Treatment of Posterior Communicating Artery Aneurysms: A Single Institutional Experience
title_sort recovery of oculomotor nerve palsy after endovascular and surgical treatment of posterior communicating artery aneurysms: a single institutional experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159044/
https://www.ncbi.nlm.nih.gov/pubmed/30283504
http://dx.doi.org/10.4103/1793-5482.238085
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