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Neuroradiology

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01-11-2017 | Interventional Neuroradiology

Recovery of oculomotor nerve palsy after endovascular treatment of ruptured posterior communicating artery aneurysm

Authors: Qing-Quan Zu, Xing-Long Liu, Bin Wang, Chun-Gao Zhou, Jin-Guo Xia, Lin-Bo Zhao, Hai-Bin Shi, Sheng Liu

Published in: Neuroradiology | Issue 11/2017

Abstract

Purpose

Oculomotor nerve palsy (ONP) may result from Posterior communicating artery (Pcom) aneurysms. Endovascular treatment of ruptured Pcom aneurysms generally is a safe procedure, but the effect of this therapy on ONP is incompletely elucidated. This retrospective study evaluates outcomes of ONP after endovascular treatment for ruptured Pcom aneurysm and with the intention to clarify predictors of recovery.

Methods

From May 2010 to October 2015, 210 patients with Pcom aneurysms underwent endovascular treatment at our institution. Among them, 34 patients with ruptured aneurysms and either complete or incomplete ONP were identified. The outcomes and predictors of ONP recovery were analyzed.

Results

At the last available clinical follow-up, ONP resolution was complete in 21 (61.8%) patients and incomplete in 8 (23.5%) patients. The mean resolution time after embolization was 24.5 days. Five patients showed no signs of ONP recovery. In no case was an initial incomplete ONP observed to worsen. There was a statistically insignificant trend toward complete recovery among patients with initial incomplete ONP (OR = 4.17; 95% CI, 0.75–23.18; P = 0.103).

Conclusion

Endovascular treatment appears to be an effective treatment modality for ruptured Pcom aneurysm and related ONP. The initial incomplete ONP might encourage complete ONP recovery after endovascular treatment.

Tan H, Huang G, Zhang T, Liu J, Li Z, Wang Z (2015) A retrospective comparison of the influence of surgical clipping and endovascular embolization on recovery of oculomotor nerve palsy in patients with posterior communicating artery aneurysms. Neurosurgery 76:687–694CrossRefPubMed

Gaberel T, Borha A, di Palma C, Emery E (2016) Clipping versus coiling in the management of posterior communicating artery aneurysms with third nerve palsy: a systematic review and meta-analysis. World Neurosurg 87:498–506.e4CrossRefPubMed

Koskela E, Laakso A, Kivisaari R, Setala K, Hijazy F, Hernesniemi J (2015) Eye movement abnormalities after a ruptured intracranial aneurysm. World Neurosurg 83:362–367CrossRefPubMed

Ahn JY, Han IB, Yoon PH, Kim SH, Kim NK, Kim S, Joo JY (2006) Clipping vs coiling of posterior communicating artery aneurysms with third nerve palsy. Neurology 66:121–123CrossRefPubMed

Chalouhi N, Theofanis T, Jabbour P, Dumont AS, Gonzalez LF, Starke RM, Gordon D, Rosenwasser R, Tjoumakaris S (2013) Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy: clinical outcomes and predictors of nerve recovery. AJNR Am J Neuroradiol 34:828–832CrossRefPubMed

Zheng F, Dong Y, Xia P, Mpotsaris A, Stavrinou P, Brinker G, Goldbrunner R, Krischek B (2017) Is clipping better than coiling in the treatment of patients with oculomotor nerve palsies induced by posterior communicating artery aneurysms? A systematic review and meta-analysis. Clin Neurol Neurosurg 153:20–26CrossRefPubMed

Guresir E, Schuss P, Setzer M, Platz J, Seifert V, Vatter H (2011) Posterior communicating artery aneurysm-related oculomotor nerve palsy: influence of surgical and endovascular treatment on recovery: single-center series and systematic review. Neurosurgery 68:1527–1533CrossRefPubMed

Guresir E, Schuss P, Seifert V, Vatter H (2012) Oculomotor nerve palsy by posterior communicating artery aneurysms: influence of surgical strategy on recovery. J Neurosurg 117:904–910CrossRefPubMed

Hassan T, Hamimi A (2013) Successful endovascular management of brain aneurysms presenting with mass effect and cranial nerve palsy. Neurosurg Rev 36:87–97CrossRefPubMed

10.

McCracken DJ, Lovasik BP, McCracken CE, Caplan JM, Turan N, Nogueira RG, Cawley CM, Dion JE, Tamargo RJ, Barrow DL, Pradilla G (2015) Resolution of oculomotor nerve palsy secondary to posterior communicating artery aneurysms: comparison of clipping and coiling. Neurosurgery 77:931–939CrossRefPubMed

11.

Kassis SZ, Jouanneau E, Tahon FB, Salkine F, Perrin G, Turjman F (2010) Recovery of third nerve palsy after endovascular treatment of posterior communicating artery aneurysms. World Neurosurg 73:11–16; discussion e2

12.

Patel K, Guilfoyle MR, Bulters DO, Kirollos RW, Antoun NM, Higgins JN, Kirkpatrick PJ, Trivedi RA (2014) Recovery of oculomotor nerve palsy secondary to posterior communicating artery aneurysms. Br J Neurosurg 28:483–487CrossRefPubMed

13.

Brigui M, Chauvet D, Clarencon F, Degos V, Sourour NA, Nouet A, Clemenceau S, Boch AL, Bernat AL, Di Maria F, Cornu P (2014) Recovery from oculomotor nerve palsy due to posterior communicating artery aneurysms: results after clipping versus coiling in a single-center series. Acta Neurochir 156:879–884PubMed

14.

Mansour N, Kamel MH, Kelleher M, Aquilina K, Thornton J, Brennan P, Bolger C (2007) Resolution of cranial nerve paresis after endovascular management of cerebral aneurysms. Surg Neurol 68:500–504CrossRefPubMed

15.

Szikora I, Marosfoi M, Salomvary B, Berentei Z, Gubucz I (2013) Resolution of mass effect and compression symptoms following endoluminal flow diversion for the treatment of intracranial aneurysms. AJNR Am J Neuroradiol 34:935–939CrossRefPubMed

16.

Zhang SH, Pei W, Cai XS, Cheng G (2010) Endovascular management and recovery from oculomotor nerve palsy associated with aneurysms of the posterior communicating artery. World Neurosurg 74:316–319CrossRefPubMed

17.

Gu DQ, Luo B, Zhang X, Long XA, Duan CZ (2012) Recovery of posterior communicating artery aneurysm-induced oculomotor nerve paresis after endovascular treatment. Clin Neurol Neurosurg 114:1238–1242CrossRefPubMed

18.

Fukuda H, Hayashi K, Yoshino K, Koyama T, Lo B, Kurosaki Y, Yamagata S (2016) Impact of aneurysm projection on intraoperative complications during surgical clipping of ruptured posterior communicating artery aneurysms. Neurosurgery 78:381–390CrossRefPubMed

19.

Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, Lamoureux J, Chagnon M, Roy D (2003) Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 34:1398–1403CrossRefPubMed

20.

Ji W, Liu A, Lv X, Kang H, Sun L, Li Y, Yang X, Jiang C, Wu Z (2016) Risk score for neurological complications after endovascular treatment of Unruptured intracranial aneurysms. Stroke 47:971–978CrossRefPubMedPubMedCentral

21.

Yang P, Zhao K, Zhou Y, Zhao R, Zhang L, Zhao W, Hong B, Xu Y, Huang Q, Krings T, Liu J (2015) Stent-assisted coil placement for the treatment of 211 acutely ruptured wide-necked intracranial aneurysms: a single-center 11-year experience. Radiology 276:545–552CrossRefPubMed

22.

Kang DH, Goh DH, Baik SK, Park J, Kim YS (2014) Morphological predictors of intraprocedural rupture during coil embolization of ruptured cerebral aneurysms: do small basal outpouchings carry higher risk. J Neurosurg 121:605–612CrossRefPubMed

23.

Yanaka K, Matsumaru Y, Mashiko R, Hyodo A, Sugimoto K, Nose T (2003) Small unruptured cerebral aneurysms presenting with oculomotor nerve palsy. Neurosurgery 52:553–557CrossRefPubMed

24.

Chang SI, Tsai MD, Wei CP (2014) Posterior communicating aneurysm with oculomotor nerve palsy: clinical outcome after aneurysm clipping. Turk Neurosurg 24:170–173PubMed

25.

Chen PR, Amin-Hanjani S, Albuquerque FC, McDougall C, Zabramski JM, Spetzler RF (2006) Outcome of oculomotor nerve palsy from posterior communicating artery aneurysms: comparison of clipping and coiling. Neurosurgery 58:1040–1046CrossRefPubMed

26.

Dimopoulos VG, Fountas KN, Feltes CH, Robinson JS, Grigorian AA (2005) Literature review regarding the methodology of assessing third nerve paresis associated with non-ruptured posterior communicating artery aneurysms. Neurosurg Rev 28:256–260CrossRefPubMed

27.

Sola T, Benitez E, Vivas E, Cuellar H, Nasis N, Guimaraens L (2008) Clinical and radiological features of posterior communicating artery aneurysms. Interv Neuroradiol 14:247–251CrossRefPubMedPubMedCentral

Title: Recovery of oculomotor nerve palsy after endovascular treatment of ruptured posterior communicating artery aneurysm
Authors: Qing-Quan Zu
Xing-Long Liu
Bin Wang
Chun-Gao Zhou
Jin-Guo Xia
Lin-Bo Zhao
Hai-Bin Shi
Sheng Liu
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 11/2017
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-017-1909-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recovery of oculomotor nerve palsy after endovascular treatment of ruptured posterior communicating artery aneurysm

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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