Lee Jong Min, Whang Kum, Cho Sung Min, Kim Jong Yeon, Oh Ji Woong, Koo Youn Moo, Hu Chul, Pyen Jinsoo, Choi Jong Wook
Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
J Cerebrovasc Endovasc Neurosurg. 2017 Sep;19(3):189-195. doi: 10.7461/jcen.2017.19.3.189. Epub 2017 Sep 30.
The Onyx liquid embolic system is a relatively safe and commonly used treatment for vascular malformations, such as arteriovenous fistulas and arteriovenous malformations. However, studies on possible complications after Onyx embolization in patients with vascular malformations are limited, and the occurrence of cranial nerve palsy is occasionally reported. Here we report the progress of two different types of cranial nerve palsy that can occur after embolization. In both cases, Onyx embolization was performed to treat vascular malformations and ipsilateral oculomotor and facial nerve palsies were observed. Both patients were treated with steroids and exhibited symptom improvement after several months. The most common types of neuropathy that can occur after Onyx embolization are facial nerve palsy and trigeminal neuralgia. Although the mechanisms underlying these neuropathies are not clear, they may involve traction injuries sustained while extracting the microcatheter, mass effects resulting from thrombi and edema, or Onyx reflux into the vasa nervorum. In most cases, the neuropathy spontaneously resolves several months following the procedure.
Onyx液体栓塞系统是一种相对安全且常用于治疗血管畸形（如动静脉瘘和动静脉畸形）的方法。然而，关于血管畸形患者接受Onyx栓塞术后可能出现的并发症的研究有限，且偶尔有颅神经麻痹的报道。在此，我们报告栓塞术后可能出现的两种不同类型颅神经麻痹的进展情况。在这两例病例中，均进行了Onyx栓塞以治疗血管畸形，并观察到同侧动眼神经和面神经麻痹。两名患者均接受了类固醇治疗，数月后症状有所改善。Onyx栓塞术后最常见的神经病变类型是面神经麻痹和三叉神经痛。尽管这些神经病变的潜在机制尚不清楚，但可能涉及拔出微导管时遭受的牵拉伤、血栓和水肿引起的占位效应，或Onyx反流至神经血管。在大多数情况下，神经病变在术后数月会自发缓解。
