Hoz Samer S, Ma Li, Ismail Mustafa, Al-Bayati Alhamza R, Nogueira Raul G, Lang Michael J, Gross Bradley A
Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
Department of Neurosurgery, Neurosurgery Teaching Hospital, Al Risafa, Baghdad, Iraq.
Surg Neurol Int. 2024 Jun 21;15:207. doi: 10.25259/SNI_379_2024. eCollection 2024.
Cranial nerve (CN) palsy may manifest as an initial presentation of intracranial aneurysms or due to the treatment. The literature reveals a paucity of studies addressing the involvement of the 6 CN in the presentation of cerebral aneurysms.
Clinical patient data, aneurysmal characteristics, and CN 6 palsy outcome were retrospectively reviewed and analyzed.
Out of 1311 cases analyzed, a total of 12 cases were identified as having CN 6 palsy at the presentation. Eight out of the 12 were found in the unruptured aneurysm in the cavernous segment of the internal carotid artery (ICA). The other four cases of CN 6 palsy were found in association with ruptured aneurysms located exclusively at the posterior inferior cerebellar artery (PICA). For the full functional recovery of the CN 6 palsy, there was 50% documented full recovery in the eight cases of the unruptured cavernous ICA aneurysm. On the other hand, all four patients with ruptured PICA aneurysms have a full recovery of CN 6 palsy. The duration for recovery for CN palsy ranges from 1 to 5 months.
The association between intracranial aneurysms and CN 6 palsy at presentation may suggest distinct patterns related to aneurysmal location and size. The abducent nerve palsy can be linked to unruptured cavernous ICA and ruptured PICA aneurysms. The recovery of CN 6 palsy may be influenced by aneurysm size, rupture status, location, and treatment modality.
颅神经（CN）麻痹可能是颅内动脉瘤的初始表现，也可能是治疗所致。文献显示，针对第6对颅神经在脑动脉瘤表现中的受累情况的研究较少。
对临床患者数据、动脉瘤特征和第6对颅神经麻痹的结果进行回顾性分析。
在分析的1311例病例中，共有12例在就诊时被确定为患有第6对颅神经麻痹。12例中的8例发现于颈内动脉（ICA）海绵窦段的未破裂动脉瘤。另外4例第6对颅神经麻痹与仅位于小脑后下动脉（PICA）的破裂动脉瘤相关。对于第6对颅神经麻痹的完全功能恢复，8例未破裂海绵窦段颈内动脉瘤中有50%记录为完全恢复。另一方面，4例小脑后下动脉破裂动脉瘤患者的第6对颅神经麻痹均完全恢复。颅神经麻痹的恢复时间为1至5个月。
就诊时颅内动脉瘤与第6对颅神经麻痹之间的关联可能提示与动脉瘤位置和大小相关的确切模式。展神经麻痹可能与未破裂的海绵窦段颈内动脉瘤和破裂的小脑后下动脉动脉瘤有关。第6对颅神经麻痹的恢复可能受动脉瘤大小、破裂状态、位置和治疗方式的影响。
