Isolated bilateral abducens nerves palsy due to traumatic delicate arteriovenous fistula.
BACKGROUND
Ocular motor dysfunction is common in patients with head trauma. Also, traumatic lateral gaze palsy is usually associated with brain stem lesion, peripheral nerve injury with or without basilar skull fracture and lateral rectus muscle injury or entrapment. However, isolated bilateral abducens nerve palsy is extremely rare.


METHODS
This study describes a case of isolated bilateral abducens nerve palsy in a 35-year-old male with head trauma without cervical and skull fractures. He was diagnosed with mild diffuse axonal injury. During his assessment, he developed mild limb weakness, an ataxic gait and impaired abductive movement in both eyes. Angiography of the left common carotid artery revealed multiple small arteriovenous fistulae in both inferior nasal conchae. After embolization, lateral gaze palsy of his eyes was significantly improved.


CONCLUSIONS
Based on this case, arteriovenous fistula should be considered as a cause of bilateral isolated abducens nerve palsy.
Chang
Jae Hyeok
JH
Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Seo-gu, Busan, Republic of Korea.
Shin
Yong Beom
YB
Sohn
Hyun Joo
HJ
Ko
Hyun-Yoon
HY
Lee
Tae Hong
TH
Ha
Yong Hoon
YH
D020434:Abducens Nerve Diseases / Q000209:etiology* / Q000503:physiopathology; D000063:Accidents, Traffic; D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000503:physiopathology; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications*; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009886:Ophthalmoplegia / Q000209:etiology* / Q000503:physiopathology