后交通动脉瘤栓塞术后的动眼神经麻痹恢复  

Recovery of the oculomotor nerve palsy after posterior communicating artery aneurysmal embolization with Guglielmi detachable coil

作　　者：胡锦清[1] 林东[1] 沈建康[1] 赵卫国[1] 

机构地区：[1]上海第二医科大学附属瑞金医院神经外科,上海200025

出　　处：《中华神经医学杂志》2004年第4期284-287,共4页Chinese Journal of Neuromedicine

摘　　要：目的 探讨电解脱弹簧圈栓塞后交通动脉瘤(PCoAA)后动眼神经麻痹恢复的可能性。方法 从2001年4月起对连续6例伴有动眼神经麻痹的未破裂PCoAA患者采用电解脱弹簧圈栓塞,其中1例宽颈动脉瘤联合载瘤动脉的支架植入。女性5例,男性1例,平均年龄61.8岁,动脉瘤最大径3～8.8 mm,从症状出现到栓塞间时间为3～23 d。结果 动脉瘤均栓塞成功,完全栓塞4个、95%栓塞2个,另外完全栓塞1个伴发的未出现症状的对侧PCoAA。除1例患者留有轻微的瞳孔不等大外,其余患者均完全恢复,恢复时间从3～6周。平均随访16.7月,未见动脉瘤再通。结论 弹簧圈栓塞PCoAA是可能有效地恢复PCoAA所致的动眼神经麻痹,特别是小型动脉瘤。Objective To investigate recovering possibility of the ocularmotor nerve palsy after posterior communicating aneurysmal embolization with electrolytically detachable coils. Methods From April 2001, six consecutive patients (5 female, 1 male, average age 61.8 years) with unruptured posterior communicating aneurysms (PcoAA), presenting oculomotor nerve palsy, were treated with embolization using electrolytically detachable coils. Of all, one wide-necked aneurysm was treated with coil embolization combined with stent implantation. The maximal diameter of the aneurysms was 3-8.8 ram. The time span between onset and therapy ranged from 3 to 23 days. Results All six aneurysms as well as one contralateral asymptomatic PCoAA were successfully embolized intraaneurysmally with coils. Four aneurysms plus the contralateral concomitant were totally embolized and two were subtotally (95 %). As a result, all patients were recovered with nerve palsy disappearing except for one with anisocoria, with recovering spans ranging from 3 to 6 weeks. No recanalization ofanenrysms was found in the follow-up of mean 16.7 months. Conclusion Endovascular embolization of PCoAAs with electrolytically detachable coils may produce satisfactory effects in eliminating oculomotor nerve palsy induced by PCoAAs, especially for small sized aneurysms.

关 键 词：后交通动脉瘤栓塞术 动眼神经麻痹 电解脱弹簧圈栓塞 动脉瘤 

分 类 号：R739.41[医药卫生—肿瘤]