Prognosis of oculomotor palsy following subarachnoid hemorrhage due to aneurysms of the posterior communicating artery

Abstract

The incidence of an unilateral oculomotor palsy due to aneurysms in the junction of the internal carotid-posterior communicating artery is about 30 to 40%. The prognosis of these palsies is dependent of several factors. These are: 1) Is the palsy complete or incomplete? 2) Could the aneurysms be surgically treated within 14 days after onset of palsy? 3) Was decompression of the oculomotor nerve achieved by surgery? Generally the levator palpebrae recovers the fastest and most frequently. The bulbus movements have the least tendency to recover. An incomplete palsy has an essentially better prognosis than a complete palsy. Recovery can be expected if palsy is present not longer than 14 days. Cases, in which the aneurysm was clipped and reduced in size, showed the best recovery of the oculomotor palsy. The results are discussed in reference to the literature and in terms of 24 patients.