由后交通动脉动脉瘤压迫所致的动眼神经麻痹并不取决于动脉瘤的大小，而是取决于颈内动脉与前、后床突之间的距离。
Third nerve palsy caused by compression of the posterior communicating artery aneurysm does not depend on the size of the aneurysm, but on the distance between the ICA and the anterior-posterior clinoid process.
作者信息
Anan Mitsuhiro, Nagai Yasuyuki, Fudaba Hirotaka, Kubo Takeshi, Ishii Keisuke, Murata Kumi, Hisamitsu Yoshinori, Kawano Yoshihisa, Hori Yuzo, Nagatomi Hirofumi, Abe Tatsuya, Fujiki Minoru
机构信息
Department of Neurosurgery, National Hospital Organization Beppu Medical Center, Japan.
Department of Neurosurgery, National Hospital Organization Beppu Medical Center, Japan.
出版信息
Clin Neurol Neurosurg. 2014 Aug;123:169-73. doi: 10.1016/j.clineuro.2014.05.006. Epub 2014 Jun 4.
OBJECTIVE
Third nerve palsy (TNP) caused by a posterior communicating artery (PCoA) aneurysm is a well-known symptom of the condition, but the characteristics of unruptured PCoA aneurysm-associated third nerve palsy have not been fully evaluated. The aim of this study was to analyze the anatomical features of PCoA aneurysms that caused TNP from the viewpoint of the relationship between the ICA and the skull base.
METHODS
Forty-eight unruptured PCoA aneurysms were treated surgically between January 2008 and September 2013. The characteristics of the aneurysms were evaluated.
RESULTS
Thirteen of the 48 patients (27%) had a history of TNP. The distance between the ICA and the anterior-posterior clinoid process (ICA-APC distance) was significantly shorter in the TNP group (p<0.01), but the maximum size of the aneurysms was not (p=0.534).
CONCLUSION
Relatively small unruptured PCoA aneurysms can cause third nerve palsy if the ICA runs close to the skull base.
目的
由后交通动脉（PCoA）动脉瘤引起的动眼神经麻痹（TNP）是该疾病的一种众所周知的症状，但未破裂的PCoA动脉瘤相关性动眼神经麻痹的特征尚未得到充分评估。本研究的目的是从颈内动脉（ICA）与颅底的关系角度分析导致TNP的PCoA动脉瘤的解剖特征。
方法
2008年1月至2013年9月期间，对48例未破裂的PCoA动脉瘤进行了手术治疗。对动脉瘤的特征进行了评估。
结果
48例患者中有13例（27%）有TNP病史。TNP组中ICA与前后床突之间的距离（ICA-APC距离）明显较短（p<0.01），但动脉瘤的最大尺寸则不然（p=0.534）。
结论
如果ICA靠近颅底走行，相对较小的未破裂PCoA动脉瘤可导致动眼神经麻痹。
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