Article
Is coiling of paralytic aneurysms a reasonable concept? An observational study
Darf man paralytische Aneurysmen coilen? Eine Beobachtungsserie
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Published: | May 8, 2006 |
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Objective: The background of this retrospective study was the question whether cranial nerve palsy would resolve after endovascular therapy of ophthalmoplegic aneurysms. The assumption is that the pulsatile effect of the aneurysm to the nerve is crucial and that not only compression of the aneurysm itself plays a role in the development of a paresis.
Methods: 22 patients with ophthalmoplegic aneurysms underwent retrospecitv evaluation with regard to the duration of the paresis before treatment and clinical outcome after endovascular treatment. Four aneurysms were located in the posterior circulation (basilar artery 3, posterior cerebral artery 1), all other aneurysms had their origin from the internal carotid artery (n=18). Occlusion of the parent artery was performed in four patients. In 18 aneurysms selective aneurysms occlusion was performed. Aneurysm size ranged from 4 to 25 mm.
Results: Improvement of the paresis occurred in the majority of patients (n=15), a transient aggravation was noted in 4 patients. Improvement correlated with a shorter duration of the paresis before treatment.
Conclusions: Ophthalmoplegic aneurysms do show improvement after endovascular therapy despite previous concerns. Obviously not only relief of the aneurysm compression but particularly elimination of the pulsatile effect plays a role in improving the paresis.