2019 年 47 巻 3 号 p. 162-166
Background and Purpose: The superior treatment modality between surgical clipping and endovascular coiling for the treatment of internal carotid-posterior communicating artery aneurysms (IC-Pcom ANs) with oculomotor nerve palsy is controversial. In the present study, we compared clipping and coiling in terms of recovery from oculomotor nerve palsy induced by IC-Pcom ANs.
Materials and Methods: The study included patients treated with clipping or coiling for IC-Pcom ANs with oculomotor nerve palsy over the past 12 years. Age, sex, diabetes mellitus (DM), subarachnoid hemorrhage (SAH), aneurysm size, severity of oculomotor nerve palsy (complete or partial), interval from onset to treatment, degree of recovery from oculomotor nerve palsy, and time to recovery were compared.
Results: Eleven patients were treated with clipping, while four were treated with coiling. No significant differences were found between the clipping and coiling cases in terms of age, sex, DM, SAH, aneurysm size, or proportion of patients with complete oculomotor nerve palsy. The coiling cases tended to be older and have a larger aneurysm. The patients with complete oculomotor nerve palsy tended to be treated with clipping. The interval from onset to treatment was significantly longer in the coiling group than in the clipping group (3.8 days vs. 46 days). The degree of improvement of oculomotor nerve palsy was significantly better in the clipping group than in the coiling group. No significant difference in the proportion of patients with full recovery of the oculomotor nerve was found between the two groups. The time to recovery from oculomotor paresis tended to be longer in the coiling group than in the clipping group.
Conclusion: Although both clipping and coiling achieved good recovery from oculomotor nerve palsy caused by IC-Pcom ANs, clipping may achieve better recovery from complete oculomotor nerve palsy in a short term after onset.
