Horikoshi T, Nukui H, Yagishita T, Nishigaya K, Fukasawa I, Sasaki H
Department of Neurosurgery, Yamanashi Medical University, Tamaho, Japan.
Neurosurgery. 1999 Apr;44(4):705-10; discussion 710-1. doi: 10.1097/00006123-199904000-00008.
The goals of this study were to evaluate the relationship between postoperative oculomotor nerve palsy and other clinical factors and to improve preoperative estimations of the risk. Such an evaluation has not been previously described in the literature.
Patient records for 77 basilar tip aneurysm cases and 28 basilar superior cerebellar artery aneurysm cases treated between 1981 and 1997 were reviewed. Clinical and radiological parameters were separately analyzed using the chi2 test, and then multiple-regression analysis was used.
Postoperative oculomotor palsy occurred in 25 (32%) patients with basilar tip aneurysms and 11 (39%) patients with basilar superior cerebellar artery aneurysms, in addition to 2 patients with basilar tip aneurysms and 3 patients with basilar superior cerebellar artery aneurysms who exhibited oculomotor palsy before surgery. For both type of aneurysms, the size and direction of the aneurysms were closely related to oculomotor nerve palsy. The complication also tended to occur in early surgery cases, in younger patients, and in patients of poor-clinical grade status.
In this study, some clinical and radiological factors were found to be associated with postoperative oculomotor nerve palsy.
本研究的目的是评估术后动眼神经麻痹与其他临床因素之间的关系，并改善术前风险评估。此前文献中尚未有此类评估报道。
回顾了1981年至1997年间治疗的77例基底动脉尖动脉瘤病例和28例基底动脉上小脑动脉动脉瘤病例的患者记录。分别使用卡方检验分析临床和放射学参数，然后进行多元回归分析。
除2例基底动脉尖动脉瘤患者和3例基底动脉上小脑动脉动脉瘤患者术前出现动眼神经麻痹外，25例（32%）基底动脉尖动脉瘤患者和11例（39%）基底动脉上小脑动脉动脉瘤患者术后出现动眼神经麻痹。对于这两种类型的动脉瘤，动脉瘤的大小和方向与动眼神经麻痹密切相关。该并发症也倾向于在早期手术病例、年轻患者和临床分级较差的患者中发生。
在本研究中，发现一些临床和放射学因素与术后动眼神经麻痹有关。
