Neurovascular compression of the abducent nerve causing abducent palsy treated by microvascular decompression. Case report.
Isolated abducent palsy is a symptom that can be caused by many different intracranial pathological conditions. In this report the authors describe the case of a patient who suffered isolated abducent palsy resulting from vascular compression of the sixth cranial nerve; surgical treatment consisted of microvascular decompression (MVD). This 56-year-old man presented with short-lasting episodes of a pulling sensation at the lateral side of his right eye associated with intermittent diplopia, followed by a progressive palsy of the abducent nerve and constant diplopia. Magnetic resonance imaging revealed a neurovascular contact of a dolichoectatic basilar artery with the abducent nerve. The patient underwent surgery consisting of a combined supra- and infratentorial presigmoid approach and subsequent MVD of the abducent nerve. Postoperatively, the abducent nerve palsy resolved within days, and the patient remains free of symptoms with a follow-up time of 4 years. This is the first report of a neurovascular compression of the abducent nerve treated successfully by MVD.
De Ridder
Dirk
D
Department of Neurosurgery, University Hospital of Antwerp, Belgium. dirk.de.ridder@uza.be
Menovsky
Tomas
T
D000010:Abducens Nerve / Q000601:surgery; D020434:Abducens Nerve Diseases / Q000209:etiology*; D019299:Decompression, Surgical; D004172:Diplopia / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D010243:Paralysis / Q000209:etiology*; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000601:surgery