Unruptured aneurysms with cranial nerve symptoms: efficacy of endosaccular Guglielmi detachable coil treatment.
OBJECTIVE
To evaluate the efficacy of endosaccular Guglielmi detachable coil (GDC) treatment of unruptured aneurysms causing cranial nerve (CN) symptoms.


METHODS
Among a database of 218 patients whose aneurysms were treated using GDC, seven patients met the criteria for unruptured aneurysms presenting with symptoms and signs of CN palsy. Changes in CN symptoms before and after GDC treatment were reviewed.


RESULTS
Aneurysms were located in the internal carotid-posterior communicating artery (n=3), the basilar bifurcation (n=1) and the cavernous internal carotid artery (n=3). CN symptoms included ptosis (n=6), mydriasis (n=2), and extraocular muscle (EOM) disorder (CN III: n=4; CN VI: n=3). Overall, improvement or resolution of CN symptoms after treatment was noted in five patients. CN symptoms in cases involving small (</= =10 mm) and intradural aneurysms tended to respond better to GDC treatment. Ptosis was the initial symptom to show improvement, while EOM dysfunction responded least favourably.


CONCLUSIONS
GDC coil packing appears to be an appropriate treatment method for the relief of CN symptoms associated with intracranial aneurysms.
Kim
Dong Joon
DJ
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, South Korea. dikim@yumc.yonsei.ac.kr
Kim
Dong Ik
DI
Lee
Seung Koo
SK
Kim
Si Yeon
SY
D003389:Cranial Nerve Diseases / Q000209:etiology*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D008875:Middle Aged