Saito Ryuta, Sugawara Takayuki, Mikawa Sigeki, Fukuda Takeshi, Kohama Misaki, Seki Hirobumi
Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.
Neurol Med Chir (Tokyo). 2008 Jul;48(7):304-6. doi: 10.2176/nmc.48.304.
Oculomotor nerve paresis caused by internal carotid-posterior communicating artery (IC-PC) aneurysm usually manifests with pupillary dysfunction. Recently, we treated three patients with unruptured IC-PC aneurysms initially manifesting as pupil-sparing oculomotor nerve paresis, which resolved after clipping of the aneurysms. Review of the 56 patients admitted to our hospital with unruptured IC-PC aneurysms between January 2000 and December 2006 identified 6 patients with oculomotor nerve disturbances, and the 3 present cases with pupil sparing. The incidence of IC-PC aneurysms manifesting as pupil-sparing oculomotor nerve paresis may be increasing with improved accessibility to medical services and wider awareness of oculomotor nerve paresis as a symptom of cerebral aneurysms. Cerebral angiography should be performed in patients with pupil-sparing oculomotor nerve paresis.
颈内动脉-后交通动脉（IC-PC）动脉瘤所致动眼神经麻痹通常表现为瞳孔功能障碍。最近，我们治疗了3例未破裂IC-PC动脉瘤患者，最初表现为瞳孔保留的动眼神经麻痹，动脉瘤夹闭后症状缓解。回顾2000年1月至2006年12月我院收治的56例未破裂IC-PC动脉瘤患者，发现6例有动眼神经功能障碍，其中3例为本病例表现为瞳孔保留。随着医疗服务可及性的提高以及对动眼神经麻痹作为脑动脉瘤症状的认识更加广泛，表现为瞳孔保留的动眼神经麻痹的IC-PC动脉瘤的发生率可能在增加。瞳孔保留的动眼神经麻痹患者应行脑血管造影检查。
