Document Detail


Recovery of third nerve palsy after endovascular treatment of posterior communicating artery aneurysms.
MedLine Citation:
PMID:  20452864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: High recovery rates after endovascular treatment of TNP-inducing PcomA aneurysms have been reported. However, only few and often small series were reported. The results of the 2 available comparative studies are controversial. Choosing clipping or coiling as treatment modality nowadays is still a matter of debate. We report the ophthalmologic outcome of 20 consecutive patients treated by coiling of TNP-inducing PcomA aneurysms. METHODS: The third nerve function before and after endovascular treatment was assessed and studied retrospectively. Predictive recovery factors known from literature including treatment timing, the degree of preoperative nerve deficit, the association with SAH, coil type, cardiovascular risk factors, and age were analyzed. A review of the literature was performed. RESULTS: Eight patients presented initially with complete nerve palsy (40%) and 12 with partial palsy (60%). Eleven patients had SAH. The mean aneurysm size was 7.14 mm; there were no partially thrombosed aneurysms. Of the 20 patients, 19 (95%) recovered. Recovery was complete in 7 patients (35%), partial in 12 patients (60%), and 1 patient remained unchanged (5%). The mean duration of follow-up was 24.7 months. One patient with complete TNP recovered completely after 5 months of coiling. One case of late complete nerve recovery was observed at 20 months. No cases of reoccurrences or worsening of the partial TNP were observed, including patients who developed recanalization of the aneurysmal sac. Clinical presentation with SAH and early management were statistically significant factors that positively influenced nerve recovery (P = .006549 and P = .015718, respectively). Initial partial TNP seems to influence recovery but did not reach significance (P = .079899). CONCLUSION: Coiling of PcomA aneurysms is associated with high rates of third nerve function recovery. Complete recovery can be expected even after long periods and in cases of initial complete nerve palsy. The early treatment and the association with SAH seem to promote the nerve recovery.
Authors:
Sebouh Z Kassis; Emmanuel Jouanneau; Florence B Tahon; Fadi Salkine; Gilles Perrin; Francis Turjman
Related Documents :
12368734 - Endoluminal versus open treatment of descending thoracic aortic aneurysms.
23279734 - Trends in mortality rates in elderly st elevation myocardial infarction patients submit...
16923974 - Endovascular treatment of visceral aneurysms associated with pancreatitis and a suggest...
23674854 - Trans-arterial chemo-embolization is safe and effective for very elderly patients with ...
24364174 - Comparison of amnion allograft with connective tissue graft for root coverage procedure...
3510704 - A prospective randomized study of sutured versus stapled bowel anastomoses in patients ...
Publication Detail:
Type:  Journal Article     Date:  2009-07-15
Journal Detail:
Title:  World neurosurgery     Volume:  73     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-6; discussion e2     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010. Published by Elsevier Inc.
Affiliation:
Department of Neurosurgery, P. Wertheimer Neurological Hospital, Pinel, Lyon, France. khassis@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty*
Cohort Studies
Embolization, Therapeutic*
Female
Humans
Intracranial Aneurysm / complications,  diagnosis,  therapy*
Male
Middle Aged
Oculomotor Nerve Diseases / etiology,  physiopathology*,  therapy*
Recovery of Function / physiology*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Coil-based endovascular treatment of single-hole cerebral arteriovenous fistulae: experiences in 11 ...
Next Document:  Posterior-to-anterior circulation access using the Penumbra Stroke System for mechanical thrombectom...