Clinical outcomes of lower cranial nerve palsies caused by vertebral artery-posteroinferior cerebellar artery aneurysms after endovascular embolization

摘要

To report clinical outcomes of lower cranial nerve palsy (LCNP) caused by vertebral artery (VA)aneurysms.Methods: Seventy-two patients with VA aneurysms, who were treated endovascularly between 2001 and2008, were retrospectively studied to identify patients presenting LCNP without hemorrhage.Results: LCNP occurred in 12 patients (16-7%) initially caused by VA aneurysms: four located at vertebralartery-posteroinferior cerebellar artery (PICA) complex, seven at distal to PICA segment and one atproximal to PICA segment. Among these patients, ten patients were diagnosed as having dissectinganeurysms of the intracranial VA, and two were diagnosed having saccular aneurysms. Two patients weretreated by sole stent placement, five patients were treated by stent coil embolization and five were treatedby vertebral artery occlusion. Nosocomial pneumonia did not occur in our patients. Post-operative LCNPresolved completely within 6 months in nine patients (75%) and within 9 months in ten patients (83%). Two(1-9%) patients died of aneurismal bleeding and brainstem ischemia, respectively.Conclusion: The results of this study can help to identify the effect and natural history of LCNP caused byVA aneurysms. These lesions can be effectively treated by endovascular embolization, even by VAocclusion.