Zu Qing-Quan, Liu Xing-Long, Wang Bin, Zhou Chun-Gao, Xia Jin-Guo, Zhao Lin-Bo, Shi Hai-Bin, Liu Sheng
Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, Jiangsu, 210029, China.
Neuroradiology. 2017 Nov;59(11):1165-1170. doi: 10.1007/s00234-017-1909-9. Epub 2017 Sep 6.
Oculomotor nerve palsy (ONP) may result from Posterior communicating artery (Pcom) aneurysms. Endovascular treatment of ruptured Pcom aneurysms generally is a safe procedure, but the effect of this therapy on ONP is incompletely elucidated. This retrospective study evaluates outcomes of ONP after endovascular treatment for ruptured Pcom aneurysm and with the intention to clarify predictors of recovery.
From May 2010 to October 2015, 210 patients with Pcom aneurysms underwent endovascular treatment at our institution. Among them, 34 patients with ruptured aneurysms and either complete or incomplete ONP were identified. The outcomes and predictors of ONP recovery were analyzed.
At the last available clinical follow-up, ONP resolution was complete in 21 (61.8%) patients and incomplete in 8 (23.5%) patients. The mean resolution time after embolization was 24.5 days. Five patients showed no signs of ONP recovery. In no case was an initial incomplete ONP observed to worsen. There was a statistically insignificant trend toward complete recovery among patients with initial incomplete ONP (OR = 4.17; 95% CI, 0.75-23.18; P = 0.103).
Endovascular treatment appears to be an effective treatment modality for ruptured Pcom aneurysm and related ONP. The initial incomplete ONP might encourage complete ONP recovery after endovascular treatment.
动眼神经麻痹（ONP）可能由后交通动脉（Pcom）动脉瘤引起。破裂的Pcom动脉瘤的血管内治疗通常是一种安全的手术，但这种治疗对ONP的影响尚未完全阐明。本回顾性研究评估破裂的Pcom动脉瘤血管内治疗后ONP的结果，旨在明确恢复的预测因素。
2010年5月至2015年10月，210例Pcom动脉瘤患者在我院接受了血管内治疗。其中，34例动脉瘤破裂且伴有完全或不完全ONP的患者被纳入研究。分析ONP恢复的结果和预测因素。
在最后一次有效的临床随访中，21例（61.8%）患者的ONP完全恢复，8例（23.5%）患者不完全恢复。栓塞后的平均恢复时间为24.5天。5例患者未显示ONP恢复迹象。无一例初始不完全ONP恶化。初始不完全ONP患者完全恢复的趋势无统计学意义（OR = 4.17；95% CI，0.75 - 23.18；P = 0.103）。
血管内治疗似乎是破裂的Pcom动脉瘤及相关ONP的有效治疗方式。初始不完全ONP可能促使血管内治疗后ONP完全恢复。
