后交通动脉瘤栓塞术后动眼神经麻痹预后分析

Oculomotor nerve palsy following posterior communicating artery aneurysm embolization: prognosis analysis

目的探讨血管栓塞治疗后交通动脉瘤性动眼神经麻痹(OMNP)预后及相关影响因素分析。方法对在2011年1月至2012年2月间血管栓塞治疗的13例大脑后交通动脉瘤伴单侧动眼神经麻痹患者临床资料进行回顾性分析,并在术后回访中对是否伴有蛛网膜下腔出血(SAH),术前OMNP程度及治疗时机等相关因素进行分析讨论。结果所有患者出院时Rankin评分均为0分。随访中完全恢复5例(38.5%),部分恢复4例(30.8%),无恢复4例(30.8%)。其中部分OMNP的患者完全恢复率(75.0%)明显高于完全OMNP患者(22.2%),而早期接受治疗的患者恢复率(55.5%)也高于中期(50.0%)及晚期(0.0%)。结论血管栓塞治疗在一定程度上能够有效改善OMNP症状,早期栓塞治疗效果更好。

Objective To discuss the prognosis of ocular motor nerve palsy （OMNP） after posterior communicating artery aneurysm clipping. Methods A total of 13 patients with oculomotor nerve palsy after coil embolization of posterior communicating artery aneurysm were analyzed retrospectively. The assessed parameters were as follows： presence of subarachnoid hemorrhage （SAH）, preoperative severity of symptoms, and timing of treatment after onset of symptoms. Results Outcomes of 13 patients estimated by Rankin Scale were 0 at discharge. Improvement of oculomotor nerve palsy after treatment was noted in 9 patients （69.2%）. Complete recovery was noted in 5 patients （38.5%）, partial recovery in 4 patients （30.8%）, and no recovery in 4 patients （30.8%）. Recovery rate from initial partial OMRP （75.0%） were higher than that from the complete OMRP （22.2%）. Recovery rate of patients （55.5%） were higher in early treatment than in the other two groups （50.0% ,0.0% ）. Conclusion Endovascular treatment is a favored method for treating OMNP, and early embolization treatment brings more satisfactory prognosis.