Eye movement abnormalities after a ruptured intracranial aneurysm

Area of Science:

• Neuroscience
• Ophthalmology
• Neurosurgery

Background:

• Eye movement abnormalities are frequently observed in patients with aneurysmal subarachnoid hemorrhage (aSAH).
• These abnormalities can significantly impact a patient's quality of life.
• The exact prevalence and recovery patterns of these deficits remain underexplored.

Purpose of the Study:

• To determine the prevalence of preoperative and postoperative eye movement abnormalities in aSAH patients.
• To assess the recovery of these abnormalities during a 1-year follow-up period.
• To investigate potential associations between eye movement deficits and patient demographics or aSAH severity.

Main Methods:

• Prospective study of 121 patients undergoing treatment for ruptured intracranial aneurysms.
• Comprehensive neuro-ophthalmic examinations conducted at multiple time points: admission, 3 days, 14 days, 2-4 months, 6 months, and 12 months (for specific conditions).
• Analysis of associations between neuro-ophthalmic findings and clinical, radiologic, and demographic data.

Main Results:

• On admission, 9% of patients showed third, fourth, or sixth nerve palsy; this increased to 13% postoperatively.
• Most palsies resolved, with only 2.5% of patients exhibiting partial palsy at 1 year.
• Horizontal gaze paresis (n=9) and Parinaud's syndrome (n=3) were also observed. No significant associations were found between neuro-ophthalmic findings and other clinical variables.

Conclusions:

• Eye movement abnormalities are common in the acute phase of aSAH.
• Significant improvement in these abnormalities is observed within one year post-treatment.
• Recognition of specific neuro-ophthalmic findings can aid in localizing the underlying neuropathology.