Trigeminal nerve palsy associated with intracranial aneurysms: Scoping review

Trigeminal nerve palsy (TNP) in patients with intracranial aneurysms (IAs) results from the disease process or its treatment. We systematically reviewed the literature on trigeminal palsy in patients with IAs.

PubMed, ScienceDirect and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction and quality assessment were performed according to preestablished guidelines.

Twenty studies were included, yielding 69 patients with TNP and IAs. The mean age was 56.9 years and females accounted for 76%. Among the total cases, a cavernous internal carotid artery aneurysm was found in the vast majority (93%), followed by 7% of aneurysms in the basilar artery-superior cerebellar artery, posterior communicating artery, and anterior communicating artery. 96% of the aneurysms were classified as large to giant-sized. Out of the total number of cases, the majority (90%) exhibited trigeminal palsy at the time of their initial presentation. Only a small proportion (n = 7, 10%) developed fifth nerve palsy subsequent to the treatment of their aneurysms. Concurrent versus isolated TNP were exhibited in 79.7% and 20.3% of the cases, respectively. Finally, in terms of outcome, complete recovery from trigeminal palsy was achieved in 76.7% (26/34), with a duration of resolution of <6 months in 77.3% (17/22).

Trigeminal nerve palsies are correlated with IAs, and this correlation depends mainly on the location and size of the aneurysms.