Unruptured Intracranial Aneurysms with Oculomotor Nerve Palsy : Clinical Outcome between Surgical Clipping and Coil Embolization

Abstract

This study indicates that no significant differences were observed in the clinical outcome between coil embolization and surgical clipping techniques in the treatment of aneurysms causing ONP. Coil embolization seems to be more feasible and safe treatment modality for the relief and recovery of oculomotor nerve palsy.

Oculomotor nerve palsy induced by internal carotid artery aneurysm: prognostic factors for recovery

“…They concluded that ONP recovery was better after surgical versus endovascular treatment (p<0.05). In 2010, the team of Busan in Korea [19] analyzed the outcome of 19 patients treated for unruptured intracranial aneurysms leading to ONP. Of the ten patients treated with embolization, six recovered totally, one partially and three did not recover, whereas in the surgical group, six patients recovered totally, two partially and one did not recover.…”

“…Moreover, in spite of the publication of six previous retrospective comparative studies and two meta-analyses, the superiority of either treatment modality remains controversial, with two series [7,24] showing a better recovery rate after surgery and four [1,3,19,21] showing no significant difference between the two treatments. Both meta-analyses available [9,14] are in favor of surgical treatment.…”

“…Equally, the positive prognostic value of subarachnoid hemorrhage (SAH) [15] and surgical treatment versus endovascular management of ONP-inducing aneurysm [1,3,7,9,14,19,21,24] remains uncertain.…”

Clipping Versus Coiling in the Management of Posterior Communicating Artery Aneurysms with Third Nerve Palsy: A Systematic Review and Meta-Analysis

“…The eleven studies were observational and were strictly retrospective. Eight studies were defined as "goodquality studies" according to the NOS score, 24,25,27,[29][30][31][32][33] and three studies were defined as poor-quality studies. 23,26,28 Nine studies recorded the patients' age; mean patient age was 53.4 years.…”

“…4,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Eleven studies met all inclusion criteria and had sufficient available data. [23][24][25][26][27][28][29][30][31][32][33] These studies had a total sample size of 384 patients with third nerve palsy due to PCoA aneurysms at baseline, of whom 257 (67.0%) were treated by clipping and 127 by coiling (33.0%). The number of patients at baseline in the M A N U S C R I P T…”