title: Isolated sixth nerve palsy from hemorrhage of a pontine cavernous malformation.
abstract: A 32-year-old woman who developed binocular horizontal diplopia was found to have an isolated fascicular sixth nerve palsy secondary to hemorrhage of a cavernous malformation within the left pontine tegmentum. There was sparing of the paramedian pontine reticular formation and absence of a horizontal gaze palsy. The natural history of cavernous malformations and a mechanism by which hemorrhage of these vascular lesions may produce minimal neurologic signs, including isolated ocular motor cranial nerve palsies, is discussed. Magnetic resonance imaging (MRI) that includes susceptibility-weighted sequences leads to their accurate diagnosis.
authors: Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Robert M
authors: RM
authors: Mallery
authors: Joshua P
authors: JP
authors: Klein
authors: Misha L
authors: ML
authors: Pless
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis* / Q000209:etiology*; D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009421:Nervous System Malformations / Q000150:complications* / Q000473:pathology*; D011149:Pons / Q000473:pathology*