Enokida M, Sakurai Y, Sato T, Oka N, Okada H, Suzuki J
No To Shinkei. 1978 Jul;30(7):789-93.
Sixty-three cases of an aneurysm at the internal carotid-posterior communicating artery junction with aneurysm-induced unilateral eye-lid ptosis, a symptom of the third nerve palsy, were described. 1) The incidence of this palsy in 189 cases of the aneurysm was thirty-three percent. 2) The palsy before the aneurysm rupture was recognized in three cases (5 percent). The onset of this palsy following an aneurysm rupture was most frequent in the first day and in almost half of the patients within two days, but in four cases the palsy appeared three or four weeks after the aneurysm rupture. 3) The size and direction of the growth of the aneurysms in carotid angiograms were compared between palsy and non-palsy groups and there were no significant differences between them. 4) Thirty-one patients who had had a palsy before direct aneurysm surgery were followed one to ten years post-operatively. In twenty-three (74 percent), the unilateral eye-lid ptosis was recovered by the follow-up. In eleven of the twelve cases operated within two weeks after the onset, the palsy was recovered. On the other hand, in seven of eight not-recovered cases there was a delay of more than two weeks before operation.
本文描述了63例颈内动脉-后交通动脉交界处动脉瘤合并动脉瘤所致单侧眼睑下垂(动眼神经麻痹症状)的病例。1)在189例动脉瘤患者中,这种麻痹的发生率为33%。2)3例(5%)患者在动脉瘤破裂前出现麻痹。动脉瘤破裂后这种麻痹最常在第一天出现,近一半患者在两天内出现,但有4例患者在动脉瘤破裂后三到四周出现麻痹。3)比较了麻痹组和非麻痹组颈动脉血管造影中动脉瘤的大小和生长方向,两组之间无显著差异。4)对31例在直接动脉瘤手术前出现麻痹的患者进行了术后1至10年的随访。23例(74%)患者的单侧眼睑下垂在随访中恢复。在发病后两周内接受手术的12例患者中,有11例麻痹恢复。另一方面,在8例未恢复的病例中,有7例在手术前延迟了两周以上。