Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1227/neu.0000000000002349 http://hdl.handle.net/11449/249081 |
Resumo: | BACKGROUND: 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. |
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Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort StudyAneurysm clippingIntracranial aneurysmOculomotor nerve palsyPcom aneurysmBACKGROUND: 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.Department of Neurology and Neurosurgery Universidade Federal de São Paulo, São PauloDepartment of Neurosurgery Faculdade de Medicina Universidade Estadual Paulista, São PauloDepartment of Neurosurgery Hospital Regional de Presidente Prudente, São PauloDepartment of Neurosurgery Instituto Estadual do Cérebro Paulo Niemeyer, Rio de JaneiroDepartment of Neurosurgery Hospital de Urgencias Governador Otavio Lage, GoaniaDepartment of Neurosurgery Hospital de Neurologia Santa Monica, GoiásDepartment of Neurosurgery Santa Casa BH, Minas GeraisDepartment of Surgery Universidade Federal de Minas Gerais, Minas GeraisDepartment of Neurosurgery Conjunto Hospitalar de Sorocaba SECONCI, São PauloDepartment of Neurosurgery Hospital São Lucas da PUCRS, Rio Grande do SulDepartmento of Ophtalmology Universidade Federal de São Paulo, São PauloDepartment of Neurosurgery Hospital Beneficencia Portuguesa de São Paulo, São PauloDepartment of Neurosurgery Faculdade de Medicina Universidade Estadual Paulista, São PauloUniversidade Federal de São Paulo (UNIFESP)Universidade Estadual Paulista (UNESP)Hospital Regional de Presidente PrudenteInstituto Estadual do Cérebro Paulo NiemeyerHospital de Urgencias Governador Otavio LageHospital de Neurologia Santa MonicaSanta Casa BHUniversidade Federal de Minas Gerais (UFMG)SECONCIHospital São Lucas da PUCRSHospital Beneficencia Portuguesa de São Pauloda Costa, Marcos Devanir SilvaLima, Joao Vitor FernadesZanini, Marco Antonio [UNESP]Filho, Pedro Tadao Hatamoto [UNESP]Naufal, Rodrigo Ferrari FernandesReys, LorenaGoes, PedroMiguez, Camila AhmedBastos, Francisco Azeredode Figueiredo Lopes, DionisioDellaretti, MarcosBuzartti, IsraelMachado Filho, Mario Alberto S.Sako, Everson AkioWainberg, Ricardo ChmelnitskyFerreira, Danilo Santosde Araujo Moura, Ana LauraChaddad-Neto, Feres2023-07-29T14:01:54Z2023-07-29T14:01:54Z2023-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1192-1198http://dx.doi.org/10.1227/neu.0000000000002349Neurosurgery, v. 92, n. 6, p. 1192-1198, 2023.1524-40400148-396Xhttp://hdl.handle.net/11449/24908110.1227/neu.00000000000023492-s2.0-85159734387Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengNeurosurgeryinfo:eu-repo/semantics/openAccess2023-07-29T14:01:54Zoai:repositorio.unesp.br:11449/249081Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-07-29T14:01:54Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
title |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
spellingShingle |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study da Costa, Marcos Devanir Silva Aneurysm clipping Intracranial aneurysm Oculomotor nerve palsy Pcom aneurysm |
title_short |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
title_full |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
title_fullStr |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
title_full_unstemmed |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
title_sort |
Risks for Oculomotor Nerve Palsy and Time to Recovery After Surgical Clipping of Posterior Communicating Artery Aneurysms: A Multicenter Retrospective Cohort Study |
author |
da Costa, Marcos Devanir Silva |
author_facet |
da Costa, Marcos Devanir Silva Lima, Joao Vitor Fernades Zanini, Marco Antonio [UNESP] Filho, Pedro Tadao Hatamoto [UNESP] Naufal, Rodrigo Ferrari Fernandes Reys, Lorena Goes, Pedro Miguez, Camila Ahmed Bastos, Francisco Azeredo de Figueiredo Lopes, Dionisio Dellaretti, Marcos Buzartti, Israel Machado Filho, Mario Alberto S. Sako, Everson Akio Wainberg, Ricardo Chmelnitsky Ferreira, Danilo Santos de Araujo Moura, Ana Laura Chaddad-Neto, Feres |
author_role |
author |
author2 |
Lima, Joao Vitor Fernades Zanini, Marco Antonio [UNESP] Filho, Pedro Tadao Hatamoto [UNESP] Naufal, Rodrigo Ferrari Fernandes Reys, Lorena Goes, Pedro Miguez, Camila Ahmed Bastos, Francisco Azeredo de Figueiredo Lopes, Dionisio Dellaretti, Marcos Buzartti, Israel Machado Filho, Mario Alberto S. Sako, Everson Akio Wainberg, Ricardo Chmelnitsky Ferreira, Danilo Santos de Araujo Moura, Ana Laura Chaddad-Neto, Feres |
author2_role |
author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Universidade Estadual Paulista (UNESP) Hospital Regional de Presidente Prudente Instituto Estadual do Cérebro Paulo Niemeyer Hospital de Urgencias Governador Otavio Lage Hospital de Neurologia Santa Monica Santa Casa BH Universidade Federal de Minas Gerais (UFMG) SECONCI Hospital São Lucas da PUCRS Hospital Beneficencia Portuguesa de São Paulo |
dc.contributor.author.fl_str_mv |
da Costa, Marcos Devanir Silva Lima, Joao Vitor Fernades Zanini, Marco Antonio [UNESP] Filho, Pedro Tadao Hatamoto [UNESP] Naufal, Rodrigo Ferrari Fernandes Reys, Lorena Goes, Pedro Miguez, Camila Ahmed Bastos, Francisco Azeredo de Figueiredo Lopes, Dionisio Dellaretti, Marcos Buzartti, Israel Machado Filho, Mario Alberto S. Sako, Everson Akio Wainberg, Ricardo Chmelnitsky Ferreira, Danilo Santos de Araujo Moura, Ana Laura Chaddad-Neto, Feres |
dc.subject.por.fl_str_mv |
Aneurysm clipping Intracranial aneurysm Oculomotor nerve palsy Pcom aneurysm |
topic |
Aneurysm clipping Intracranial aneurysm Oculomotor nerve palsy Pcom aneurysm |
description |
BACKGROUND: 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. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-07-29T14:01:54Z 2023-07-29T14:01:54Z 2023-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1227/neu.0000000000002349 Neurosurgery, v. 92, n. 6, p. 1192-1198, 2023. 1524-4040 0148-396X http://hdl.handle.net/11449/249081 10.1227/neu.0000000000002349 2-s2.0-85159734387 |
url |
http://dx.doi.org/10.1227/neu.0000000000002349 http://hdl.handle.net/11449/249081 |
identifier_str_mv |
Neurosurgery, v. 92, n. 6, p. 1192-1198, 2023. 1524-4040 0148-396X 10.1227/neu.0000000000002349 2-s2.0-85159734387 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Neurosurgery |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
1192-1198 |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1803047455699238912 |