Recovery of posterior communicating artery aneurysm-induced oculomotor nerve paresis after endovascular treatment

Clin Neurol Neurosurg. 2012 Nov;114(9):1238-42. doi: 10.1016/j.clineuro.2012.03.016. Epub 2012 Mar 29.


Objective: Recovery of aneurysm-induced oculomotor nerve paresis (ONP) after endosaccular coiling has not yet been adequately assessed. The aim of this study was to investigate the factors that affect the outcome of ONP after endovascular treatment of posterior communicating artery (PcomA) aneurysms.

Materials and methods: We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 36 patients with ONP due to PcomA aneurysms treated by endovascular coiling. Univariate analysis was applied to test the association between ONP recovery and clinical variables.

Results: Thirty-six consecutive patients (20 women, 16 men; mean age, 54.3±9 years) presenting with ONP underwent endosaccular coiling were enrolled in this study. Subarachnoid hemorrhage was present in 21 patients. The mean size of the aneurysms was 9.3±3.9mm. ONP was complete in 14 patients (38.9%) and partial in 22 patients (61.1%) at admission. Seventeen patients (47.2%) had complete recovery of oculomotor nerve function, 15 had incomplete recovery (41.7%), and 4 (11.1%) remained unchanged after treatment. Factors showing significant association with recovery of oculomotor nerve function were the length and degree of ONP before treatment (P=0.035 and P=0.019, respectively).

Conclusions: Endosaccular coiling of PcomA aneurysms in patients with ONP resulted in cure or improvement of oculomotor nerve dysfunction in the majority of patients. The length and degree of preoperative ONP were the statistically significant predictors of complete ONP recovery.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / complications
  • Data Interpretation, Statistical
  • Endovascular Procedures*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Ophthalmoplegia / etiology*
  • Ophthalmoplegia / physiopathology
  • Posterior Cerebral Artery*
  • Postoperative Complications / physiopathology*
  • Recovery of Function
  • Stents
  • Subarachnoid Hemorrhage / epidemiology
  • Subarachnoid Hemorrhage / surgery