Comparative Analysis of the Risk Factors Influencing Recovery of Function from Oculomotor Nerve Palsy in Unruptured and Ruptured Posterior Communicating Artery Aneurysms.

Aim: To assess the risk factors and simultaneously compared the benefits of procedures (clipping vs. coiling) in the recovery of function from oculomotor nerve palsy (OMNP) between cases with unruptured and ruptured posterior communicating artery (PCOM) aneurysms.

Material and methods: Among the 225 cases of aneurysm treated in our department between July 2018 and February 2020, 25 patients with PCOM aneurysm with OMNP (unruptured: n=13; ruptured: n=12) were retrospectively analysed.

Results: The average duration from onset of symptoms to treatment in unruptured PCOM aneurysm cases was 13.33 ± 3.76 days compared with 7.41 ± 2.42 days in ruptured aneurysm cases. Moreover, an 80% improvement was observed when OMNP was treated within 17 days with the earliest improvement noticed in 33.05 ± 18.75 days in unruptured aneurysm cases compared with 39.66 ± 31.75 days in ruptured PCOM aneurysm cases. Stepwise logistic regression analysis revealed that the type of aneurysm (better recovery in unruptured aneurysm cases) was a significant risk factor (p=0.0126), but not the procedure (clipping vs. coiling) performed, for function recovery from OMNP.

Conclusion: Patients with unruptured PCOM aneurysms with OMNP have a better recovery rate than those with ruptured PCOM aneurysms. No procedural (clipping vs. coiling) advantages were observed on the recovery of function from OMNP. Transmitted pulsation reduction significantly affects the recovery of function from OMNP.