Surgical Clipping of Vertebrobasilar Aneurysms and Oculomotor Nerve Palsy – A Single Institutional Experience

Osama Iqbal Ahmed, MD1, Lissa Baird, MD1, Rishi Wadhwa, MD1, Anil Nanda, MD1

1Shreveport, LA United States

Keywords: aneurysm, cranial nerve, aneurysm repair, basilar artery, outcome

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Abstract

     One of the morbidities associated with surgical clipping of basilar aneurysms is oculomotor nerve palsy. However the incidence of oculomotor nerve palsy is less reported in the literature.
     We report our single institutional experience with basilar aneurysms and oculomotor nerve palsy.
     This is a chart review of 59 patients with basilar aneurysms from 1993 to 2008 at our institution.
     Multiple variables were assessed to gather risk identifying factors for oculomotor nerve palsy. All surgical clippings were performed at LSUHSC Shreveport.
     Of 38 patients, 29 patients (76%) that underwent surgical clipping presented with subarachnoid hemorrhage. 2 of the 38 (5%) patients presented with an oculomotor nerve palsy, both of which had a preoperative subarachnoid hemorrhage. After surgical clipping, 5 of the 38 (13%) patients had a new onset of oculomotor nerve palsy. A total of 7 patients out of the 38 (18%) were discharged from the hospital with a third nerve palsy. 3 of the 38 (8%) patients did not have any resolution of their oculomotor nerve palsy, while 4 out of the 38 (11%) had complete resolution of their oculomotor nerve palsy.
     This is a retrospetive study.
     The results of this study describe the incidence of oculomotor nerve with surgical clipping of basilar aneurysms.
     Our incidence of oculomotor nerve palsy was 18%, with over half of the patients having complete resolution of their nerve palsy. 8% of the patients had no to partial resolution of their oculomotor nerve palsy.


Acknowledgements

Project Roles:

O. Ahmed (), L. Baird (), R. Wadhwa (), A. Nanda ()