Journal of Korean Society of Geriatric Neurosurgery 2018;14(2):60-65.
Published online September 1, 2018.
Clinical Analysis of Oculomotor Nerve Palsy with an Unruptured Posterior Communicating Artery Aneurysm in Elderly Patients
Jeong Kyun Joo , Jong Il Choi , Chang Hyun Kim , Ho Kook Lee , Jae Gon Moon , Tack Geun Cho
Department of Neurosurgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
고령 환자에서 동안 신경 마비를 초래한 비파열성 후교통동맥류에 대한 임상 분석
The purpose of this study is to clinical analyze in cases of oculomotor nerve palsy with an unruptured posterior communicating artery aneurysm in elderly patients(≥65 years) and compare them with other literatures.
A total of 8 patients who had unilateral oculomotor palsy and posterior communicating artery aneurysm as revealed in angiography were reviewed. All patients were women over 65 years. Aneurysm clipping or coil embolization was performed as an emergency procedure. The patients were divided into 3 groups(complete palsy vs. incomplete palsy, early treatment vs. delayed treatment, aneurysm clipping vs. coil embolization). Complete recovery, partial recovery, and no recovery ratio of each group were obtained.
The first noticeable change was improvement of the pupil reflex(mean duration: >7.9 weeks) followed by improvement of ptosis(>10.6 weeks) and diplopia(>26.3 weeks). In the incomplete palsy and early treatment groups, recovery of the oculomotor nerve palsy was rapid and the complete recovery rate was high. The prognosis was similar after aneurysm clipping or coil embolization. Complete recovery was observed in 5 patients(62.5%), partial recovery in 2 patients(25%), and no recovery in 1 patient(12.5%).
Early treatment of oculomotor nerve palsy with an unruptured posterior communicating artery aneurysm yielded satisfactory recovery and oculomotor nerve palsy can be reversible in elderly patients.
Key Words: Endovascular procedure, Oculomotor nerve palsy, Posterior communicating artery aneurysm

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