Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study

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dc.contributor.authorda Costa, Marcos Devanir Silva
dc.contributor.authorLima, Joao Vitor Fernades
dc.contributor.authorZanini, Marco Antonio [UNESP]
dc.contributor.authorFilho, Pedro Tadao Hatamoto [UNESP]
dc.contributor.authorNaufal, Rodrigo Ferrari Fernandes
dc.contributor.authorReys, Lorena
dc.contributor.authorGoes, Pedro
dc.contributor.authorMiguez, Camila Ahmed
dc.contributor.authorBastos, Francisco Azeredo
dc.contributor.authorde Figueiredo Lopes, Dionisio
dc.contributor.authorDellaretti, Marcos
dc.contributor.authorBuzartti, Israel
dc.contributor.authorMachado Filho, Mario Alberto S.
dc.contributor.authorSako, Everson Akio
dc.contributor.authorWainberg, Ricardo Chmelnitsky
dc.contributor.authorFerreira, Danilo Santos
dc.contributor.authorde Araujo Moura, Ana Laura
dc.contributor.authorChaddad-Neto, Feres
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionHospital Regional de Presidente Prudente
dc.contributor.institutionInstituto Estadual do Cérebro Paulo Niemeyer
dc.contributor.institutionHospital de Urgencias Governador Otavio Lage
dc.contributor.institutionHospital de Neurologia Santa Monica
dc.contributor.institutionSanta Casa BH
dc.contributor.institutionUniversidade Federal de Minas Gerais (UFMG)
dc.contributor.institutionSECONCI
dc.contributor.institutionHospital São Lucas da PUCRS
dc.contributor.institutionHospital Beneficencia Portuguesa de São Paulo
dc.date.accessioned2023-07-29T14:01:54Z
dc.date.available2023-07-29T14:01:54Z
dc.date.issued2023-06-01
dc.description.abstractBACKGROUND: Aneurysms of the posterior communicating segment of carotid artery (PcomA) have a high risk of rupture; when these nonruptured aneurysms are associated with oculomotor nerve palsy (ONP), the risk of rupture increases compared with asymptomatic nonruptured PcomA. OBJECTIVE: To retrospectively analyze the risk factors involved in ONP secondary to PcomA aneurysm and to study the factors involved in the recovery time of ONP once it is established. METHODS: This was a retrospective study of patients from 10 neurosurgery centers from October 2008 to December 2020. We analyzed age at diagnosis, presence of compressive neuropathy of the oculomotor nerve, presence of aneurysm rupture, largest aneurysm diameter, aneurysm projection, smoking, hypertension, diabetes, time between diagnosis and surgical treatment, as well as the outcome. RESULTS: Approximately 1 in 5 patients (119/511 23.3%) with a PcomA presented with ONP. We found that patients with aneurysms measuring greater than or equal to 7.5 mm were 1.6 times more likely to have ONP than those with aneurysms smaller than 7.5 mm. In our study, the prevalence of smoking in the PcomA + ONP group was 57.76%, and we also found that smokers were 2.51 times more likely to develop ONP. A total of 80.7% showed some degree of improvement, and 45.4% showed complete improvement with a median recovery time of 90 days. CONCLUSION: This study showed that 80.7% of patients with PcomA aneurysms undergoing surgical treatment with aneurysm clipping showed some degree of improvement of the ONP, with a median time to recovery between 90 and 120 days.en
dc.description.affiliationDepartment of Neurology and Neurosurgery Universidade Federal de São Paulo, São Paulo
dc.description.affiliationDepartment of Neurosurgery Faculdade de Medicina Universidade Estadual Paulista, São Paulo
dc.description.affiliationDepartment of Neurosurgery Hospital Regional de Presidente Prudente, São Paulo
dc.description.affiliationDepartment of Neurosurgery Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro
dc.description.affiliationDepartment of Neurosurgery Hospital de Urgencias Governador Otavio Lage, Goania
dc.description.affiliationDepartment of Neurosurgery Hospital de Neurologia Santa Monica, Goiás
dc.description.affiliationDepartment of Neurosurgery Santa Casa BH, Minas Gerais
dc.description.affiliationDepartment of Surgery Universidade Federal de Minas Gerais, Minas Gerais
dc.description.affiliationDepartment of Neurosurgery Conjunto Hospitalar de Sorocaba SECONCI, São Paulo
dc.description.affiliationDepartment of Neurosurgery Hospital São Lucas da PUCRS, Rio Grande do Sul
dc.description.affiliationDepartmento of Ophtalmology Universidade Federal de São Paulo, São Paulo
dc.description.affiliationDepartment of Neurosurgery Hospital Beneficencia Portuguesa de São Paulo, São Paulo
dc.description.affiliationUnespDepartment of Neurosurgery Faculdade de Medicina Universidade Estadual Paulista, São Paulo
dc.format.extent1192-1198
dc.identifierhttp://dx.doi.org/10.1227/neu.0000000000002349
dc.identifier.citationNeurosurgery, v. 92, n. 6, p. 1192-1198, 2023.
dc.identifier.doi10.1227/neu.0000000000002349
dc.identifier.issn1524-4040
dc.identifier.issn0148-396X
dc.identifier.scopus2-s2.0-85159734387
dc.identifier.urihttp://hdl.handle.net/11449/249081
dc.language.isoeng
dc.relation.ispartofNeurosurgery
dc.sourceScopus
dc.subjectAneurysm clipping
dc.subjectIntracranial aneurysm
dc.subjectOculomotor nerve palsy
dc.subjectPcom aneurysm
dc.titleRisks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Studyen
dc.typeArtigo
unesp.author.orcid0000-0001-7874-7452[18]

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