Recurrent Isolated Abducens Nerve Paresis Associated with Persistent Trigeminal Artery Variant

Abstract

We report a 74-year-old woman who presented with recurrent isolated abducens nerve paresis. Cranial magnetic resonance imaging revealed that the right abducens nerve was sandwiched between the right internal carotid artery and a persistent trigeminal artery (PTA) variant, which might have led to neurovascular compression of the abducens nerve, resulting in abducens nerve damage. Normal variants of PTA, which are cerebellar arteries originating from a precavernous portion of the internal carotid artery, must be carefully observed as such variants can potentially cause a neurovascular compression of the abducens nerve.

Rupture of persistent primitive trigeminal artery-basilar artery aneurysm managed with stent-assisted coiling

“…This might suggest that these vascular lesions are present more often than causal in PPTA. [ 28 ] The PPTA has also been seen concomitantly with such diverse nonvascular disorders as pituitary adenoma,[ 25 ] hemifacial spasm, cranial nerve paresis,[ 39 ] and trigeminal neuralgia;[ 40 ] its occurrence in vascular abnormalities such as Moyamoya disease,[ 24 ] arteriovenous malformations,[ 41 ] carotid-cavernous fistula,[ 42 ] or alterations of the internal carotid artery (ICA)[ 4 ] has also been reported. As we have said, the association of PPTA with intracranial aneurysms has recently be found to be relatively high, up to 29% of the patients with PTA.…”

Parálisis del nervio abducens asociada a punción dural y a compresión neurovascular

“…Aunque la parálisis recurrente del VI PC es frecuente en niños, rara vez ocurre en adultos (5) (6). La compresión neurovascular puede causar un daño reversible del VI PC en adultos (5).…”

Chronic Sixth Nerve Palsy due to Compression by the Anterior Inferior Cerebellar Artery

“…9 Every patient experienced spontaneous improvement, and four out of five cases had recurrent sixth nerve palsies and the number of episodes varied from 4 to 11. [6][7][8][9] The time to recovery varied from 2 to over 4 months. 7,10 No neurosurgical treatment was pursued in any of the cases.…”

“…5,6 Five previous cases of neurovascular compression of the AICA on the abducens nerve resulting in a 6NP have been described. [6][7][8][9][10] The location of the compression was at the root entry zone in four cases, and the abducens nerve was sandwiched between a persistent trigeminal artery and the AICA in one case. 9 Every patient experienced spontaneous improvement, and four out of five cases had recurrent sixth nerve palsies and the number of episodes varied from 4 to 11.…”

“…[6][7][8][9][10] The location of the compression was at the root entry zone in four cases, and the abducens nerve was sandwiched between a persistent trigeminal artery and the AICA in one case. 9 Every patient experienced spontaneous improvement, and four out of five cases had recurrent sixth nerve palsies and the number of episodes varied from 4 to 11. [6][7][8][9] The time to recovery varied from 2 to over 4 months.…”