后交通动脉瘤所致动眼神经麻痹患者的血管内治疗
Endovascular Treatment of Patients with Oculomotor Nerve Palsy Induced by Posterior Communicating Artery Aneurysms.
作者信息
Shimoda Kentaro, Kano Toshikazu, Kurata Genya, Kanazawa Yu, Furuichi Makoto, Yoshino Atsuo
机构信息
Department of Neurosurgery, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama, Japan.
Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
出版信息
J Neuroendovasc Ther. 2020;14(9):366-372. doi: 10.5797/jnet.oa.2020-0001. Epub 2020 Jun 25.
OBJECTIVE
Whether coiling is the best treatment option for oculomotor nerve palsy (ONP) induced by posterior communicating artery (PComA) aneurysms remains controversial. In this study, we retrospectively analyzed the recovery of ONP caused by PComA aneurysms.
METHODS
Between 2007 and 2019, 8 patients with PComA aneurysms and ONP underwent coiling at our institution. We retrospectively reviewed ONP recovery, duration from onset of ONP to treatment, and complications of procedures.
RESULTS
At the last available clinical follow-up, ONP recovery was complete in 4 patients (50%) and partial in 4 patients (50%). Patients with partial recovery of ONP had sequelae of eye movement impairment that did not affect daily life. In 1 patient, hemiplegia developed due to cerebral infarction of the corona radiata the day after coiling, but it fully recovered 1 year after operation. The delay from the onset of ONP to coiling was significantly related to partial ONP recovery (r = -0.83, p = 0.01).
CONCLUSION
Endovascular treatment is a relatively safe and satisfactory treatment for PComA aneurysms with ONP.
目的
对于由后交通动脉（PComA）动脉瘤导致的动眼神经麻痹（ONP），血管内栓塞术是否为最佳治疗选择仍存在争议。在本研究中，我们回顾性分析了PComA动脉瘤所致ONP的恢复情况。
方法
2007年至2019年间，8例患有PComA动脉瘤及ONP的患者在我院接受了血管内栓塞术。我们回顾性分析了ONP的恢复情况、从ONP发作到治疗的时间以及手术并发症。
结果
在最后一次可用的临床随访中，4例患者（50%）的ONP完全恢复，4例患者（50%）部分恢复。ONP部分恢复的患者存在不影响日常生活的眼球运动障碍后遗症。1例患者在血管内栓塞术后次日因放射冠脑梗死出现偏瘫，但术后1年完全恢复。从ONP发作到血管内栓塞术的延迟与ONP部分恢复显著相关（r = -0.83，p = 0.01）。
结论
血管内治疗对于伴有ONP的PComA动脉瘤是一种相对安全且令人满意的治疗方法。
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