Rate of third nerve palsy recovery following endovascular management of cerebral aneurysms
Rate of third nerve palsy recovery following endovascular management of cerebral aneurysms
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DOI：
10.1007/s10143-007-0089-1
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发表时间：
2007-10-01
影响因子：
2.8
通讯作者：
Galvan, George M.
中科院分区：
文献类型：
--
作者：
Bulsara, Ketan R.;Jackson, Daniel;Galvan, George M.
导致第三神经麻痹的脑动脉瘤的血管内治疗已被提议作为显微外科夹扎术的替代方法。尚未评价大患者人群血管内治疗后的第三神经功能恢复。对MEDLINE、PubMed和科克伦数据库进行了第三神经麻痹和脑动脉瘤血管内治疗的文献检索。对这些研究中报告的所有患者进行了系统汇编。52例继发于脑动脉瘤的第三神经麻痹患者接受了血管内治疗。血管内治疗导致65%患者的第三神经在一定程度上恢复。21例患者报告了恢复程度。其中71%完全康复。文献中至少报告了两例手术相关的第三神经麻痹。一个是永久性的。报告一例复发性疼痛性麻痹。显微外科夹扎脑动脉瘤的第三神经麻痹恢复率为93%，第三神经完全恢复率为43%。脑动脉瘤的血管内治疗可以减轻某些患者的第三神经麻痹。然而，在回顾世界文献时，显微外科结扎夹与较高的第三神经恢复率相关。在记录了恢复程度的患者亚组中，血管内治疗显示出更高的完全恢复率。
Endovascular management of cerebral aneurysms resulting in third nerve palsies has been proposed as an alternative to microsurgical clip ligation. Third nerve function recovery following endovascular treatment in a large patient population has not been evaluated. A literature search of MEDLINE, PubMed, and Cochrane databases for third nerve palsies and endovascular management of cerebral aneurysms was performed. All reported patients in these studies were systematically compiled. Fifty-two patients with third nerve palsies secondary to cerebral aneurysms underwent endovascular treatment. Endovascular management resulted in some degree of third nerve recovery in 65% of patients. The extent of recovery was reported in 21 patients. Of these, 71% had complete recovery. At least two procedure-related third nerve palsies are reported in the literature. One was permanent. One case of recurrent painful palsy is also reported. Microsurgical clip ligation of cerebral aneurysms has a 93% rate of third nerve palsy recovery and a 43% rate of complete third nerve recovery. Endovascular management of cerebral aneurysms can alleviate third nerve palsies in some patients. In reviewing the world literature, however, microsurgical clip ligation is associated with a higher rate of third nerve recovery. Endovascular management, in the subset of patients in whom extent of recovery was documented, demonstrated a higher rate of complete recovery.