title: Delayed-onset bilateral abducens paresis after head trauma.
abstract: Bilateral sixth nerve paresis following closed head injury, though rare, is a known entity. However, delayed-onset post-traumatic bilateral abducens paresis is extremely rare. We present two cases. The first patient had onset of bilateral abducens paresis 2 weeks after closed head injury and the second patient after 3 days. The cause in the former was detected to be chronic subdural hematoma and in the latter is speculated to be edema/ischemia due to injury to soft tissue structures housing these nerves. The delayed onset of bilateral abducens paresis following head injury may vary according to the cause. There may be another mechanism of injury apart from direct trauma. Though rare, it needs to be evaluated and may have a treatable cause like elevated intracranial pressure.
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India. salunke@yahoo.co.uk
authors.forename: Pravin
authors.initials: P
authors.lastname: Salunke
authors.forename: Amey
authors.initials: A
authors.lastname: Savardekar
authors.forename: Sukumar
authors.initials: S
authors.lastname: Sura
mesh_terms: D020222:Abducens Nerve Injury / Q000000981:diagnostic imaging* / Q000209:etiology; D000063:Accidents, Traffic; D000328:Adult; D016489:Head Injuries, Closed / Q000150:complications / Q000000981:diagnostic imaging*; D020200:Hematoma, Subdural, Chronic / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult