Small Unruptured Cerebral Aneurysms Presenting with Oculomotor Nerve Palsy

Yanaka, Kiyoyuki; Matsumaru, Yuji; Mashiko, Ryota; Hyodo, Akio; Sugimoto, Koichi; Nose, Tadao

doi:10.1227/01.neu.0000047816.02757.39

Cited by 98 publications

(65 citation statements)

References 15 publications

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“…2,4,6,7,14) Fortunately we were able to treat both aneurysms successfully by endovascular procedures. Detailed neurological evaluation is often difficult in the acute phase of SAH.…”

Section: Discussionmentioning

confidence: 89%

Simultaneous Presentation of Two Cerebral Aneurysms

Yoshida

Ezura

Sasaki

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…2,4,6,7,14) Fortunately we were able to treat both aneurysms successfully by endovascular procedures. Detailed neurological evaluation is often difficult in the acute phase of SAH.…”

Section: Discussionmentioning

confidence: 89%

Simultaneous Presentation of Two Cerebral Aneurysms

Yoshida

Ezura

Sasaki

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…It is important because oculomotor palsy may occur as a result of relatively small aneurysms in this location. 3,103) Sixteen patients with small, unruptured cerebral aneurysms, 5.8 mm on average, presented with oculomotor palsy. 103) Retrobulbar pain is also a prominent feature in the majority of aneurysmal oculomotor palsies.…”

Section: Oculomotor Palsy and Unruptured Cerebral Aneurysmsmentioning

confidence: 99%

“…3,103) Sixteen patients with small, unruptured cerebral aneurysms, 5.8 mm on average, presented with oculomotor palsy. 103) Retrobulbar pain is also a prominent feature in the majority of aneurysmal oculomotor palsies. 54) The same symptom was found in 11 of 16 cases, 103) and 7 Symptomatic Unruptured Cerebral Aneurysms of 8 cases.…”

Section: Oculomotor Palsy and Unruptured Cerebral Aneurysmsmentioning

confidence: 99%

“…103) Retrobulbar pain is also a prominent feature in the majority of aneurysmal oculomotor palsies. 54) The same symptom was found in 11 of 16 cases, 103) and 7 Symptomatic Unruptured Cerebral Aneurysms of 8 cases. 43) Cadaveric and animal studies demonstrated that the oculomotor nerve contains sensory fibers that enter the brain stem and reach the spinal trigeminal nucleus, suggesting that retrobulbar pain observed in the cases with ipsilateral IC-PC aneurysms is related to these sensory fibers.…”

Section: Oculomotor Palsy and Unruptured Cerebral Aneurysmsmentioning

confidence: 99%

“…62) The time between onset and surgical therapy is very important; surgical intervention was performed within 4.7 ± 3.3 days in cases with complete recovery, 24.2 ± 15.5 days in cases with partial recovery, and 41.0 ± 12.7 days in cases with no recovery. 103) Direct clipping is commonly chosen as the method of surgical intervention for IC-PC aneurysms; there are also reports of coil embolization for these aneurysms. Coil embolization was performed in 11 patients with unruptured IC-PC aneurysms and oculomotor palsy and detailed neuroophthalmological analyses carried out.…”

Section: Oculomotor Palsy and Unruptured Cerebral Aneurysmsmentioning

confidence: 99%

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Symptomatic Unruptured Cerebral Aneurysms: Features and Surgical Outcome

Date

2010

Neurol. Med. Chir.(Tokyo)

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Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of``symptomatic'' aneurysms is higher than for``asymptomatic'' aneurysms; so``symptomatic'' aneurysms are more often surgically treated. Many reviews examine``asymptomatic'' unruptured cerebral aneurysms, but few evaluate``symptomatic'' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms.

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