Early improvement of bilateral abducens nerve palsies following surgery of an anterior communicating artery aneurysm

Isolated Unilateral Sixth Nerve Palsy as a Presenting Symptom of Cerebral Aneurysms

“…The proposed mechanism responsible for the sixth nerve dysfunction is stretching of the nerve from the growing aneurysm as the nerve enters the cavernous sinus through Dorello's canal in the case of the paraclinoid aneurysm. In the case of the patient with the distal AICA aneurysm, the proposed mechanism responsible for the nerve dysfunction is stretching of the nerve from the acutely expanding aneurysm at its emergence from the pontomedullary sulcus 7 . We feel that the mild pain which in both cases preceded the sixth nerve palsy was more likely related to the acute distension of the aneurysms secondary to rapid growth or partial thrombosis.…”

Bilateral abducens nerve palsy following ruptured anterior communicating artery aneurysm: report of 2 cases

“…Isolated or combined palsies of the sixth nerve had been reported in various aneurysm localisations, including; infraclinoid internal carotid, intracavernous carotid, anterior communicating, basilar, superior cerebellar, vertebral and posterior inferior cerebellar arteries 1,4,5,7 . Several mechanisms have been proposed to explain the bilateral involvement of the abducens nerve after an aneurysm rupture such as: direct compression of the aneurysm, elevated intracranial pressure, vasospasm of the pontine branches of the basilar artery affecting the abducens nuclei and direct compression of the clot on the nerve in the prepontine cistern especially 7 . Because of far way from the anterior communicating artery the mechanism of bilateral sixth nerve involvement following aneurysm rupture has been debated.…”

“…and the deficits had resolved completely three months after admission 5 . In the second case, Ziyal et al (2003) speculated that direct compression of both abducens nerves was caused by the extensive clot in the basal cisterns and bilateral palsies fully recovered on the third postoperative day 7 .…”

Abducens Nerve Palsy in a Patient With a Parasagittal Meningioma

“…Even intracisternal accumulation of blood due to bleeding of a ruptured aneurysm may compress the nerve. 14) Intracranial hypotension secondary to myelography or shunting may cause stretching of the abducens nerve at the petrous apex due to downward migration of the brain. 5,6) Stretching of the medial wall of the Meckel's cave may also cause abducens nerve palsy.…”

“…1,2,[4][5][6]8,11,14) Abducens nerve palsy may be caused by trauma, tumor, increased intracranial pressure, intracranial aneurysm and subarachnoid hemorrhage, 14) infection, demyelinating disease, and other diseases. Tumors that are located close to the nerve, such as tumors in the cavernous sinus, are quite common causes of abducens nerve palsy.…”