Purpose: The aim of this study was to analyze ocular signs and symptoms in patients with oculomotor nerve palsy due to compression exerted by an intracranial aneurysm. We compare the results of two surgical treatments (microsurgical clipping against endovascular embolisation) in relation with the size of the aneurysm and the time between diagnosis and therapeutical approach.
Materials and methods: The study involved 16 patients. Each patient underwent an ophthalmological evaluation at the baseline and immediately, 6 months and 1 year after surgery, including the study of eyelid ptosis, ocular motility, pupil function, non-concomitant strabismus, diplopia and visual acuity.
Results: The best recovery was seen in the patients undergoing aneurysm clipping. Palpebral ptosis was the first sign to appear and the first to regress, followed by pupil and medial rectus function. Recovery of the other muscles was slower and often incomplete.
Conclusions: Ophthalmological examination is essential for the correct treatment and follow-up of patients with intracranial aneurysms.
Keywords: diplopia; endovascular coiling; intracranial aneurysms; microsurgical clipping; oculomotor nerve palsy.