• World Neurosurg · Aug 2018

    Ruptured Vertebral Artery Dissecting Aneurysm as a Risk Factor for Ocular Symptoms Accompanied with Subarachnoid Hemorrhage.

    • Yosuke Moteki, Yasunari Niimi, Yoshikazu Okada, and Takakazu Kawamata.
    • Department of Neurosurgery, Tokyo Women's Medical University Hospital, Tokyo, Japan; Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan; Department of Neurosurgery, St. Luke's International Hospital, Tokyo, Japan. Electronic address: moteki.yosuke@twmu.ac.jp.
    • World Neurosurg. 2018 Aug 1; 116: e505-e512.

    ObjectiveAlthough ruptured vertebral artery dissecting aneurysms (VADAs) are often associated with ocular symptoms, such as abducent nerve palsy and Terson syndrome (TS), their frequency and risk factors in comparison with those associated with ruptured aneurysms in other locations have not been reported.MethodsThree hundred forty-three patients with nontraumatic subarachnoid hemorrhage were treated in our hospital from April 2002 to May 2016, among which 35 (10.2%) had VADA as the origin of hemorrhage. They were analyzed retrospectively for risk factors of ocular symptoms.ResultsOf the 343 patients, 26 had eye movement disturbance (7.6%) and 22 had TS (6.4%). Both eye movement disturbance (14 patients; 40.0%; P < 0.0001) and TS (10 patients; 28.6%; P < 0.0001) occurred more frequently in the VADA than the non-VADA group. Abducent nerve palsy accounted for all eye movement disturbances associated with ruptured VADA, although it occurred in 6 of 12 affected patients with ruptured aneurysms in other locations. Of these patients, 4 improved within 3 months (28.6%) and 8 did so within 1 year (66.7%). Multivariate logistic regression analysis indicated that ruptured VADA is a risk factor for both eye movement disturbance and TS (P < 0.0001 and P = 0.0033; 95% confidence interval of odds ratio: 3.41-29.5 and 1.72-14.33, respectively).ConclusionsEye movement disturbance and TS occurs more frequently in patients with ruptured VADA than with aneurysms in other locations. Early evaluation by an ophthalmologist is recommended in these patients.Copyright © 2018 Elsevier Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…