Oculomotor Nerve Palsy after Surgery for Upper Basilar Artery Aneurysms

Oculomotor Nerve Palsy after Surgery for Upper Basilar Artery Aneurysms ABSTRACTOBJECTIVE:The goals of this study were to evaluate the relationship between postoperative oculomotor nerve palsy and other clinical factors and to improve preoperative estimations of the risk. Such an evaluation has not been previously described in the literature.METHODS:Patient records for 77 basilar tip aneurysm cases and 28 basilar superior cerebellar artery aneurysm cases treated between 1981 and 1997 were reviewed. Clinical and radiological parameters were separately analyzed using the χ2 test, and then multiple-regression analysis was used.RESULTS:Postoperative oculomotor palsy occurred in 25 (32%) patients with basilar tip aneurysms and 11 (39%) patients with basilar superior cerebellar artery aneurysms, in addition to 2 patients with basilar tip aneurysms and 3 patients with basilar superior cerebellar artery aneurysms who exhibited oculomotor palsy before surgery. For both type of aneurysms, the size and direction of the aneurysms were closely related to oculomotor nerve palsy. The complication also tended to occur in early surgery cases, in younger patients, and in patients of poor-clinical grade status.CONCLUSION:In this study, some clinical and radiological factors were found to be associated with postoperative oculomotor nerve palsy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Oculomotor Nerve Palsy after Surgery for Upper Basilar Artery Aneurysms

Oculomotor Nerve Palsy after Surgery for Upper Basilar Artery Aneurysms

Oculomotor Nerve Palsy after Surgery for Upper Basilar Artery Aneurysms Toru Horikoshi, M.D., Hideaki Nukui, M.D., Tsutomu Yagishita, M.D., Kazuyuki Nishigaya, M.D., Isao Fukasawa, M.D., Hideo Sasaki, M.D. D e p a r t m e n t o f N e u r o s u r g e r y ( T H , H N , T Y , K N ) , Y a m a n a s h i M e d i c a l U n i v e r s i t y , a n d K o f u - )o h n a n H o s p it a l (IF , H S ) , K o fu , Y a m a n a s h i , J a p a n O B JE C T IV E : T h e g o a ls o f t h is s t u d y w e r e to e v a lu a t e the r e la t io n s h ip b e tw e e n p o s t o p e r a t iv e o c u lo m o t o r n e r v e p a ls y and other c l i n i c a l f a c t o r s a n d to im p r o v e p r e o p e r a t iv e e s t im a t io n s o f the r is k . S u c h a n e v a lu a t io n h a s n o t b e e n p re vio u sly d e s c r ib e d in th e lit e r a t u r e . M E T H O D S : P a tie n t r e c o r d s f o r 7 7 b a s ila r tip a n e u r y s m ca s e s a n d 2 8 b a s ila r s u p e r io r c e r e b e ll a r a r t e r y a n e u r y s m cases treated b e tw e e n 1 9 8 1 a n d 1 9 9 7 w e r e r e v ie w e d . C l i n i c a l a n d r a d i o l o g ic a l p a r a m e t e r s w e r e s e p a r a t e ly analyzed u s in g the \ 2 test, a n d th e n m u lt ip le - r e g r e s s io n a n a ly s is w a s u se d . RESULTS: P o s to p e r a tiv e o c u lo m o t o r p a ls y o c c u r r e d in 2 5 ( 3 2 % ) p a tie n ts w it h b a s ila r tip a n e u r y s m s a n d 1 1 ( 3 9 % ) patients w it h b a s ila r s u p e r io r c e r e b e l l a r a r t e r y a n e u r y s m s , in a d d it io n to 2 p a tie n ts w it h b a s ila r tip a n e u r y s m s a n d 3 patients w it h b a s ila r s u p e r io r c e r e b e l l a r a r t e r y a n e u r y s m s w h o e x h ib it e d o c u lo m o t o r p a ls y b e fo re s u r g e r y . F o r both type o f a n e u r y s m s , th e s iz e a n d d i r e c t io n o f the a n e u r y s m s w e re c lo s e ly r e la t e d to o c u lo m o t o r n e r v e p a ls y . The c o m p...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199904000-00008
Publisher site
See Article on Publisher Site

Abstract

ABSTRACTOBJECTIVE:The goals of this study were to evaluate the relationship between postoperative oculomotor nerve palsy and other clinical factors and to improve preoperative estimations of the risk. Such an evaluation has not been previously described in the literature.METHODS:Patient records for 77 basilar tip aneurysm cases and 28 basilar superior cerebellar artery aneurysm cases treated between 1981 and 1997 were reviewed. Clinical and radiological parameters were separately analyzed using the χ2 test, and then multiple-regression analysis was used.RESULTS:Postoperative oculomotor palsy occurred in 25 (32%) patients with basilar tip aneurysms and 11 (39%) patients with basilar superior cerebellar artery aneurysms, in addition to 2 patients with basilar tip aneurysms and 3 patients with basilar superior cerebellar artery aneurysms who exhibited oculomotor palsy before surgery. For both type of aneurysms, the size and direction of the aneurysms were closely related to oculomotor nerve palsy. The complication also tended to occur in early surgery cases, in younger patients, and in patients of poor-clinical grade status.CONCLUSION:In this study, some clinical and radiological factors were found to be associated with postoperative oculomotor nerve palsy.

Journal

NeurosurgeryOxford University Press

Published: Apr 1, 1999

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