Postoperative recovery of aneurysm of posterior communicating artery-induced oculomotor palsy: clinical observation of 52 cases

Abstract

To explore the prognosis of aneurysm of posterior communicating artery-induced oculomotor palsy after surgery. Fifty-two patients with aneurysm of posterior communicating artery-induced oculomotor palsy, 12 males and 40 females, aged 57, diagnosed by CT, MRI, and digital subtraction angiography, were divided into 2 groups: group A (n = 20, receiving simple clipping of the aneurysmal neck) and group B (n = 32, undergoing clipping of the aneurysmal neck followed by nerve decompression such as resection or puncture of the aneurysmal sac), and were followed up for 12 months (2-48 months). In the group A 10 patients were operated on within 14 days after the onset of oculomotor palsy showed complete recovery of the oculomotor nerve function within 40 days after operation; 8 patients were operated on within 14-30 days after the onset of oculomotor palsy showed complete recovery within 30-90 days after operation in 7 patients and incomplete recovery in 1 patient; and 2 patients were operated on 30 days after the onset of oculomotor palsy showed complete recovery within 6 months after operation in 1 patient and incomplete recovery in the other patient. In the group B 15 patients were operated on within 14 days after the onset of oculomotor palsy all showed complete recovery within 40 days after operation; 14 patients were operated on within 14-30 days after the onset of oculomotor palsy showed complete recovery within 30-90 days after operation in 12 patients and incomplete recovery in 2 patients; and 3 patients were operated on 30 days after the onset of oculomotor palsy showed complete recovery within 6 months after operation in 2 patients and incomplete recovery in the other one patient. There was no significant difference in the recovery rate between these 2 groups. Recovery of the oculomotor nerve function was remarkably correlated with the time of operation after the onset. Early diagnosis and treatment help recover the oculomotor nerve function. The recovery of the oculomotor nerve function is not related to the operation protocols.