Endosaccular coil embolization for intradural aneurysms presenting oculomotor nerve palsy

Abstract

Purpose: To review the clinical outcome of endosaccular coil embolization for intradural aneurysms presenting oculomotor nerve palsy. Materials and Methods: We treated 6 cases of intradural aneurysms presenting oculomotor nerve palsy. There were 4 cases of subarachnoid hemorrhage and 2 cases of non-ruptured aneurysms. The aneurysms were located at 4 internal carotid-posterior communicating artery (IC-PC) in 4 cases, internal carotid-anterior choroidal artery (IC-AchoA) in another and at basilar artery-superior cerebellar artery (BA-SCA) in the other. The size of the aneurysms ranged from 5.8 to 8.7 mm. Four cases presented complete oculomotor nerve palsy, and 2 cases incomplete. Results: Complete recovery from oculomotor nerve palsy was achieved in 4 cases and partial recovery in 2 cases. Two cases with pre-operative incomplete oculomotor nerve palsy recovered completely. To facilitate recovery from oculomotor nerve palsy, loose packing of the aneurysmal bleb was intentionally performed in selected cases. Conclusion: In spite of persistent anatomical contact or close proximity of the aneurysm to the oculomotor nerve, endosaccular coil embolization is an effective treatment in comparison to surgical clipping. The presence of the pre-operative oculomotor nerve palsy does not influence the selection of the clipping or coiling treatment methods. © 2009, The Japanese Society for Neuroendovascular Therapy. All rights reserved.