Koh Masaki, Kuwayama Naoya, Akioka Naoki, Kashiwazaki Daina, Kuroda Satoshi
Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama.
No Shinkei Geka. 2015 Oct;43(10):893-900. doi: 10.11477/mf.1436203142.
This study aimed to assess the effects of endovascular treatment on cranial nerve palsy due to unruptured intracranial aneurysms. Endovascular coiling was performed in 203 patients with intracranial aneurysms between April 2002 and March 2012 in our hospital. Of these patients, 8(3.9%)presented with cranial nerve palsy due to unruptured intracranial aneurysms. Cranial nerve palsy involved the oculomotor nerve in 8 patients and the optic nerve in 2 patients. Two patients had both optic nerve and oculomotor nerve dysfunction. Patients with incomplete oculomotor nerve palsy at admission were more likely to have full recovery after coiling. Optic nerve dysfunction did not improve after coiling. Incomplete oculomotor nerve palsy, early treatment(≤15 days), and small aneurysms(≤10 mm)were likely to be associated with complete recovery after coiling. This study indicates that endovascular coiling may resolve cranial nerve palsy due to unruptured intracranial aneurysms in patients who have incomplete oculomotor nerve palsy due to small aneurysms and are treated as early as possible after symptom onset.
本研究旨在评估血管内治疗对未破裂颅内动脉瘤所致颅神经麻痹的影响。2002年4月至2012年3月期间,我院对203例颅内动脉瘤患者进行了血管内栓塞治疗。其中,8例(3.9%)患者因未破裂颅内动脉瘤出现颅神经麻痹。8例患者的颅神经麻痹累及动眼神经,2例累及视神经。2例患者同时存在视神经和动眼神经功能障碍。入院时动眼神经麻痹不完全的患者在栓塞治疗后更有可能完全恢复。栓塞治疗后视神经功能障碍未改善。动眼神经麻痹不完全、早期治疗(≤15天)和小动脉瘤(≤10mm)可能与栓塞治疗后完全恢复有关。本研究表明,对于因小动脉瘤导致动眼神经麻痹不完全且在症状出现后尽早接受治疗的患者,血管内栓塞治疗可能会缓解未破裂颅内动脉瘤所致的颅神经麻痹。