Document Detail


Resolution of cranial nerve paresis after endovascular management of cerebral aneurysms.
MedLine Citation:
PMID:  17597189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This work aimed to study the outcome of endovascular (coiling and balloon occlusion) treatment in patients with aneurysmal mass effect (ophthalmoplegia due to third, fourth, or sixth CN paresis) and to compare it with the outcome of clipping (from the international literature). We looked at the outcome of endovascular treatment of CNP (third, fourth, and sixth) due to aneurysmal mass effect (PcomA aneurysms and intracavernous carotid aneurysms). METHODS: Between January 1999 and December 2004, 820 patients presented with aneurysmal SAH and/or mass effect. Eleven of these patients (1%) presented with third, and/or fourth, and/or sixth nerve dysfunctions and underwent endovascular treatment. The degree of the ophthalmoplegia was recorded at presentation, 2 months, 6 months, and yearly intervals thereafter. We correlated recovery of CNP to SAH, duration of the symptoms, degree of CNP, type of CNP, microvascular risks (age, diabetes mellitus, hypertension, and smoking), aneurysm size, and degree of coiling or balloon occlusion. RESULTS: The study showed a favorable outcome of endovascular treatment in the majority of patients. Resolution of CN dysfunctions occurred in 7 (64%) of 11 patients. The late follow-up showed that all the 7 patients are resuming normal life activities. This compares favorably to the results after clipping in [Leivo, Hemesniemi, Luukkonen, & Vapalahti, 1996] (41%). Presentation with SAH and isolated third CNP correlated with a better resolution of CNP (P < .05). CONCLUSION: Although mass effect remains after endovascular packing, CNP improves comparably to the recovery observed after surgical clipping. It seems likely that the decrease in aneurysmal pulsatility is responsible for the improvement of the CNP. The relatively atraumatic approach associated with endovascular management explains the favorable results. All previous reports assessed the outcome of only the third CNP after endovascular treatment in a very limited number of cases. To the best of our knowledge, this is the first study to assess the outcome of various CNP after endovascular treatment.
Authors:
Nassir Mansour; Mahmoud Hamdy Kamel; Michael Kelleher; Kristian Aquilina; John Thornton; Paul Brennan; Ciaran Bolger
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Publication Detail:
Type:  Journal Article     Date:  2007-06-26
Journal Detail:
Title:  Surgical neurology     Volume:  68     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-26     Completed Date:  2008-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  500-4; discussion 504     Citation Subset:  IM    
Affiliation:
Department of Neurology and Neurosurgery Beaumont Hospital, Dublin, Ireland. nmanso1@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Balloon Occlusion*
Cranial Nerve Diseases / etiology,  physiopathology,  prevention & control*
Embolization, Therapeutic*
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / complications,  physiopathology,  therapy*
Male
Middle Aged
Nerve Compression Syndromes / etiology,  physiopathology,  prevention & control*
Recovery of Function / physiology
Retrospective Studies
Treatment Outcome

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


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