Slowly Recovering Isolated Bilateral Abducens Nerve Palsy after Embolization of Ruptured Anterior Communicating Artery Aneurysm.
10.3340/jkns.2013.53.2.112
- Author:
Jin Sue JEON
1
;
Sang Hyung LEE
;
Young Je SON
;
Young Seob CHUNG
Author Information
1. Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Anterior communicating artery;
Subarachnoid hemorrhage;
Abducens nerve palsy
- MeSH:
Abducens Nerve;
Abducens Nerve Diseases;
Aneurysm;
Aneurysm, Ruptured;
Angiography;
Arteries;
Brain Stem;
Cerebrospinal Fluid Pressure;
Diplopia;
Dizziness;
Drainage;
Headache;
Hemorrhage;
Humans;
Infarction;
Intracranial Aneurysm;
Magnetic Resonance Imaging;
Membranes;
Paresis;
Seizures;
Subarachnoid Hemorrhage;
Surgical Instruments
- From:Journal of Korean Neurosurgical Society
2013;53(2):112-114
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bilateral abducens nerve palsy related to ruptured aneurysm of the anterior communicating artery (ACoA) has only been reported in four patients. Three cases were treated by surgical clipping. No report has described the clinical course of the isolated bilateral abducens nerve palsy following ruptured ACoA aneurysm obliterated with coil. A 32-year-old man was transferred to our institution after three days of diplopia, dizziness and headache after the onset of a 5-minute generalized tonic-clonic seizure. Computed tomographic angiography revealed an aneurysm of the ACoA. Magnetic resonance imaging showed focal intraventricular hemorrhage without brain stem abnormalities including infarction or space-occupying lesion. Endovascular coil embolization was conducted to obliterate an aneurysmal sac followed by lumbar cerebrospinal fluid (CSF) drainage. Bilateral paresis of abducens nerve completely recovered 9 weeks after ictus. In conclusion, isolated bilateral abducens nerve palsy associated with ruptured ACoA aneurysm may be resolved successfully by coil embolization and lumbar CSF drainage without directly relieving cerebrospinal fluid pressure by opening Lillequist's membrane and prepontine cistern.
