Efficacy Analysis Of 42 Patients With Posterior Communicating Arteryaneurysm Accompancy With The Ocilomotor Nerve Palsy Treated With Endovascular Embolization And Surgical Clipping

Objective: To investigate the prognosis of surgical clipping and endovascular embolization in the treatment of posterior communicating artery caused the oculomotor nerve palsy.Methods: 42 patients with posterior communicating artery caused the unilateral oculomotor nerve palsy,including 13 with surgical clipping and 29 with endovascular embolization,were enrolled in this retrospective study from January 2012 to September 2016 from the First Affiliated Hospital Of Guangxi Medical University.Therapeutic modalities,severity of preoperative the oculomotor nerve palsy,whether having preoperative subarachnoid hemorrhage,the diameter of aneurysm,and time interval of treatment were statistically analyzed.Result:1.Of the 13 patients in the surgical clipping group,11 had SAH and2 had no SAH on admission;4 had partial OMNP and 9 had complete OMNP;5aneurysms were on the left side,7 were on the right side and 1 was bilateral;The diameter of aneurysm in 4 patients was >7 mm and in 9 was ≤ 7mm.;The time interval of treatment in 9 patients was ≤ 7d and 4 > 7d.2.Of the 29 patients in the endovascular embolization group.20 had SAH and 9 had no SAH on admission;13 had partial OMNP and 16 had complete OMNP;17 aneurysm were on the left side,7 were on the right side and 5 was bilateral;The diameter of aneurysm in 18 patients was > 7mm and in 11 was ≤7mm;The time interval of treatment in 21 patients was ≤ 7 and 8 > 7d.3.The result of following up:1).In the surgical clipping group,4 patients had partial OMNP before surgery,finally 3 patients recovered completely,0recovered partially,and 1 did not recover;9 patients had completely OMNP before surgery,finally 5 patients recovered completely,3 recovered partially and 1 did not recover.The final modified Rankin scale scores were 0 point in 12 patients and 1 point in 1 patient.2)In the endovascular embolization group,13 patients had partial OMNP before surgery,finally 8 patients recovered completely,4 recovered partially,and 7 did not recover;16 patients had completely OMNP before surgery,finally 4 patients recovered completely,5recovered partially and 7 did not recover.The final modified Rankin scale scores were 0 point in 12 patients,1 point in 2 patient,and 2 point in 1patient.Conclusion:Both of the surgical clipping and endovascular embolizationcan improve the OMNP effectively,but the surgical clipping seem to be better.In the factors that affect the postoperative recovery of OMNP,the severity of preoperative OMNP and SAH teed to have a better recovery,but the recovery of the OMNP after surgery was affected by many factors,it need many double blind trial to evaluate comprehensively.