Abstract:
OBJECTIVE:Large or giant internal carotid artery (ICA) aneurysms often cause visual deficits and cranial nerve palsy. The aim of this study was to investigate the efficacy of ligation of the ICA with high-flow bypass. METHODS:We retrospectively analyzed the findings from patients with visual deficit and ophthalmologic symptoms due to ICA aneurysms. In addition, we analyzed the recovery factors associated with the visual deficit and ophthalmologic symptoms postoperatively, focusing on the type of cranial nerve palsy, aneurysm size, location, and the time to treatment from first symptoms. RESULTS:We identified 38 patients (35 women, 3 men) with a mean age at surgery of 63.6 years (range, 24-81 years) with visual and ophthalmologic symptoms due to large or giant internal carotid aneurysm. Aneurysms ranged in size from 15-50 mm (mean, 25.2 mm). Visual disturbance (7 cases, 18%) and ophthalmoplegia (31 cases, 82%) were the only preoperative cranial nerve palsies. Aneurysms were completely thrombosed in 94.7% of cases (36/38). Visual disturbance improved in 28.5% of cases (2/7), and ophthalmoplegia improved in 87.1% of cases (27/31). Time to therapy from developing a visual disturbance was longer than time to therapy from developing ophthalmoplegia (P = 0.001). Time to therapy was significantly associated with recovery from cranial nerve palsy (P < 0.0001). The recovery of visual disturbance was worse than that of ophthalmoplegia (P = 0.001). CONCLUSION:Early treatment is recommended when the visual and ophthalmologic symptoms are present because treatment delay is a risk factor for nonimprovement of symptoms.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Matano F,Murai Y,Mizunari T,Tamaki T,Tateyama K,Koketsu K,Tanikawa R,Kamiyama H,Kobayashi S,Morita Adoi
10.1016/j.wneu.2016.10.082subject
Has Abstractpub_date
2017-02-01 00:00:00pages
182-188eissn
1878-8750issn
1878-8769pii
S1878-8750(16)31071-3journal_volume
98pub_type
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journal_title:World neurosurgery
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.03.049
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pub_type: 杂志文章,meta分析
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2014.05.028
更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2016-09-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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