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血管内治疗后后交通动脉瘤所致动眼神经麻痹的恢复情况

Recovery of posterior communicating artery aneurysm-induced oculomotor nerve paresis after endovascular treatment.

作者信息

Gu Da-Qun, Luo Bin, Zhang Xin, Long Xiao-Ao, Duan Chuan-Zhi

机构信息

Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 253# Industry Road, Guangzhou, Guangdong, China.

出版信息

Clin Neurol Neurosurg. 2012 Nov;114(9):1238-42. doi: 10.1016/j.clineuro.2012.03.016. Epub 2012 Mar 29.

DOI:10.1016/j.clineuro.2012.03.016
PMID:22464656
Abstract

OBJECTIVE

Recovery of aneurysm-induced oculomotor nerve paresis (ONP) after endosaccular coiling has not yet been adequately assessed. The aim of this study was to investigate the factors that affect the outcome of ONP after endovascular treatment of posterior communicating artery (PcomA) aneurysms.

MATERIALS AND METHODS

We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 36 patients with ONP due to PcomA aneurysms treated by endovascular coiling. Univariate analysis was applied to test the association between ONP recovery and clinical variables.

RESULTS

Thirty-six consecutive patients (20 women, 16 men; mean age, 54.3±9 years) presenting with ONP underwent endosaccular coiling were enrolled in this study. Subarachnoid hemorrhage was present in 21 patients. The mean size of the aneurysms was 9.3±3.9mm. ONP was complete in 14 patients (38.9%) and partial in 22 patients (61.1%) at admission. Seventeen patients (47.2%) had complete recovery of oculomotor nerve function, 15 had incomplete recovery (41.7%), and 4 (11.1%) remained unchanged after treatment. Factors showing significant association with recovery of oculomotor nerve function were the length and degree of ONP before treatment (P=0.035 and P=0.019, respectively).

CONCLUSIONS

Endosaccular coiling of PcomA aneurysms in patients with ONP resulted in cure or improvement of oculomotor nerve dysfunction in the majority of patients. The length and degree of preoperative ONP were the statistically significant predictors of complete ONP recovery.

摘要

目的

囊内栓塞术后动脉瘤所致动眼神经麻痹(ONP)的恢复情况尚未得到充分评估。本研究旨在探讨影响后交通动脉(PcomA)动脉瘤血管内治疗后ONP预后的因素。

材料与方法

我们回顾性评估了36例因PcomA动脉瘤接受囊内栓塞治疗而出现ONP患者的临床特征及动眼神经功能预后。采用单因素分析来检验ONP恢复与临床变量之间的关联。

结果

本研究纳入了36例连续出现ONP并接受囊内栓塞治疗的患者(20例女性,16例男性;平均年龄54.3±9岁)。21例患者存在蛛网膜下腔出血。动脉瘤平均大小为9.3±3.9mm。入院时,14例患者(38.9%)的ONP为完全性,22例患者(61.1%)为部分性。治疗后,17例患者(47.2%)动眼神经功能完全恢复,15例患者(41.7%)恢复不完全,4例患者(11.1%)无变化。与动眼神经功能恢复显著相关的因素是治疗前ONP的长度和程度(分别为P=0.035和P=0.019)。

结论

ONP患者PcomA动脉瘤的囊内栓塞术使大多数患者的动眼神经功能障碍得到治愈或改善。术前ONP的长度和程度是ONP完全恢复的统计学显著预测因素。

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