Ocular complications following surgery for vertebrobasilar aneurysms

Abstract

Thirty patients undergoing surgery for aneurysms of the vertebrobasilar circulation between 1986-1990 were assessed retrospectively to determine the frequency of postoperative ocular complications. Surgery to lesions involving the upper basilar trunk and bifurcation resulted in complications in 15 of 20 patients (75%), with 72% developing a third nerve palsy. The majority of complications resolved but permanent neurological sequelae included four third nerve palsies, two sixth nerve palsies and one seventh nerve palsy in addition to two visual field defects. Aneurysms involving the lower vertebrobasilar circulation were unlikely to cause ocular problems. Postoperative neuro-ophthalmic assessment is important to identify and treat any permanent ocular motility deficit.

Key Words:

• vertebrobasilar aneurysms
• sub-temporal approach
• sub-occipital approach
• third nerve palsy
• sixth nerve palsy
• visual field deficit