Recovery of posterior communicating artery aneurysm induced oculomotor nerve palsy: a comparison between surgical clipping and endovascular embolization

BMC Neurol. 2020 Sep 18;20(1):351. doi: 10.1186/s12883-020-01847-5.

Abstract

Background: Oculomotor nerve palsy (ONP) is a common symptom of posterior communicating artery aneurysm (PcomAA) that can lead to impaired eye movement and pupil dilation. Currently, surgical clipping and endovascular embolization are the two most popular treatment methods for PcomAA-induced ONP; however, the recovery outcome between the two methods remains to be elucidated.

Methods: In the present study, we thoroughly compared the pretreatment factors and recovery outcome of the two treatments on 70 patients with PcomAA-induced ONP. The patients were separated into two groups based on the treatment that was received. Pretreatment factors, including age, sex, time period between ONP onset and treatment, ONP type, aneurysm diameter, status of subarachnoid hemorrhage and aneurysm rupture were recorded for each individual patient. Recovery outcome of the patients was assessed over a 12-month period.

Results: No significant differences were observed in any of the analyzed factors. Importantly, we revealed a significantly higher full recovery rate for the patients receiving the surgical clipping treatment than the ones that received the endovascular embolization treatment. In addition, we showed that patients' age was negatively correlated with the recovery extent in both treatment groups.

Conclusions: The outcome of our study suggests that surgical clipping might be a better option to treat PcomAA-induced ONP.

Keywords: Aneurysm; Endovascular embolization; Nerve palsy; Surgical clipping.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / methods*
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Oculomotor Nerve Diseases / etiology*
  • Recovery of Function*
  • Retrospective Studies
  • Surgical Instruments