Endovascular packing of intracranial aneurysm with preservation of the parent vessel has become in many cases a valid alternative to surgical clipping. Regression of oculomotor disorders after clipping of internal carotid-posterior communicating artery (ICA-PCoA) aneurysms has been well assessed. This report focuses on the reversal of third nerve palsy after endovascular packing of ICA-PCoA aneurysms. To this end, clinical appearances, neuroradiological features, and endovascular interventional procedures of six treated patient are reported and discussed in the light of the very few previous case observations found in the literature. Results indicate that endovascular packing of ICA-PCoA aneurysms may produce effective recovery of correlated third nerve dysfunction.
HamerJ: Prognosis of oculomotor palsy in patients with aneurysms of the posterior communicating artery. Acta Neuroch66: 173–185, 1982.
2.
KisselJTBurdeRM: Pupil-sparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms. Ann Neurol13: 149–154, 1983.
3.
O'ConnorPSTrediciTJGreenRP: Pupillary-sparing third nerve palsy due to aneurysm: A survey of 2419 neurological surgeons. J Neurosurg58: 792–793, 1983.
4.
SoniSR: Aneurysms of the posterior communicating artery and oculomotor paresis. J Neurol Neurosurg Psychiatry37: 475–484, 1974.
5.
LeivoSHernesniemiJ: Early surgery improves the cure of aneurysm-induced oculomotor palsy. Surg Neurol45: 430–434, 1996.
6.
FujiwaraSFujiiK: Oculomotor nerve palsy in patients with cerebral aneurysms. Neurosurg Rev12: 123–132, 1989.
7.
GiombiniSFerraresiSPluchinoF: Reversal of oculomotor disorders after intracranial aneurysm surgery. Acta Neurochir (Wien)112: 19–24, 1991.
8.
FeelyMKapoorS: Third nerve palsy due to posterior communicating artery aneurysm: The importance of early surgery. J Neurol Neurosurg Psychiatry50: 1051–1052, 1987.
9.
KyriakidesTAzizTZTorrensMJ: Postoperative recovery of third nerve palsy due to posterior communicating aneurysms. Br J Neurosurg3: 109–112, 1989.
10.
BirchallDMakhanSKMcAuliffeW: Resolution of third nerve paresis after endovascular management of aneurysms of the posterior communicating artery. Am J Neuroradiol20: 411–413, 1999.
11.
BradacGBBerguiM: Trattamento endovasculare di aneurismi in pazienti con deficit del III nervo cranico. Abstract Book XV Congresso Nazionale Associazione Italiana di Neuroradiologia, Firenze 1998: 64.
12.
GuglielmiGViñuelaF: Electrothrombosis of saccular aneurysms via endovascular approach. Part 1. Electrochemical basis, technique, and experimental results. J Neurosurg75: 1–7, 1991.
13.
GuglielmiGViñuelaF: Electrothrombosis of saccular aneurysms via endovascular approach. Part 2. Preliminary clinical experience. J Neurosurg75: 8–14, 1991.
14.
PiaHW: Aneurysms of the internal carotid artery (ICA) and posterior communicating artery (PCoA) and anterior choroidal artery (AChA) region. In: PiaHWLangmaidCZierskiJ (eds): Cerebral aneurysms. Advances in diagnosis and therapy. Springer-Verlag, Berlin1979: 93–95.
15.
YasargilMG: Carotid-posterior communicating aneurysms. In: YasargilMG (ed): Microneurosurgery. II clinical considerations, surgery on the intracranial aneurysms and results. Thieme-Stratton Inc, New York1984: 71–77.
16.
CognardCWeillA: Intracranial berry aneurysms: Angiographic and clinical results after endovascular treatment. Radiology206: 499–510, 1998.
17.
FranceJF: Examples of ptosis with illustrative remarks. Guys Hosp Rep4: 37–63, 1846.
18.
HutchinsonJ: Aneurysm of the internal carotid within the skull diagnosed eleven years before the patient's death. Spontaneous cure. Trans Clin Soc Lond8: 127–131, 1875.
19.
LanzinoGAndreoliA: Orbital pain and unruptured posterior communicating artery aneurysms: The role of sensory fibers of the third cranial nerve. Acta Neurochir120: 7–11, 1993.
20.
BotterellEHLloydLAHoffmanHJ: Oculomotor palsy due to supraclinoid internal carotid artery berry aneurysm. A long-term study of the results of surgical treatments on the recovery of third-nerve function. Am J Ophtalmol54: 609–616, 1962.
21.
HalbachVVHigashidaRT: The efficacy of endosaccular aneurysm occlusion in alleviating neurological deficits produced by mass effect. J Neurosurg80: 659–666, 1994.
22.
MalischTWGuglielmiG: Unruptured aneurysms presenting with mass effect symptoms: Response to endosaccular treatment with Guglielmi detachable coils. Part I. Symptoms of cranial nerve dysfunction. J Neurosurg89: 956–961, 1998.
