Experience of microsurgical treatment of posterior communicating artery aneurysms and influence of resecting the sac on the recovery of oculomotor nerve palsy

Objective The influences of removing of the sac of aneurysm on the postoperative oculomotor nerve’s recovery were studied to explore better surgical methods which facilitate the recovery of posterior communicating artery aneurysm-indued oculomotor nerve palsy.Methods The operations of 17 patients with posterior communicating artery aneurysm-induced oculomotor nerve palsy and diamater of the aneurysms over 8 milimeter,were retrospectively analyzed during July 2002 to October 2005,in which 6 patients’ aneurysms were cliped simply (group A) and 11 patients’ aneurysm sacs were removed after clipping (group B).Results Six months after operation,oculomotor nerve palsy of 12 patients recoverd completely (70.6%) and partially in five(29.4%).2 of group A recovered completely(33.3%) and 4 recovered partially(66.7%).10 of group B recovered completely (90.9%) and 1 recovered partially(9.1%).The difference between the two groups was significant (P=0.028).Follow-up for 1 year,2 of group A still recovered partially,11 of group B all recovered completely.The difference between the two groups was significant (P=0.006).Conclusions Comparing resecting the sac of aneurysm during operation with clipping alone,the former was associated with a higher probability of recovery of oculomotor nerve palsy.Possibly,the sac of aneurysm should be excised intraoperatively.