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Ruptured anterior communicating artery aneurysm causing bilateral abducens nerve paralyses--case report
1Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita.
Neurologia Medico-Chirurgica
|January 1, 1992
Summary
A rare case of bilateral abducens nerve paralysis occurred after an anterior communicating artery aneurysm rupture. This condition, often linked to subarachnoid hemorrhage, typically resolves with treatment.
Area of Science:
- Neuroscience
- Neurosurgery
- Ophthalmology
Background:
- Ruptured anterior communicating artery (AcoA) aneurysms are a significant cause of subarachnoid hemorrhage (SAH).
- Abducens nerve palsy, affecting eye movement, can be a complication of intracranial pathologies.
- Bilateral abducens nerve paralysis is an uncommon presentation following cerebrovascular events.
Observation:
- A 56-year-old female presented with sudden severe headache, indicative of SAH.
- Clinical examination revealed bilateral abducens nerve paralyses without other neuro-ophthalmological deficits.
- Imaging confirmed SAH and an AcoA aneurysm measuring 15 mm, directed antero-inferiorly.
Findings:
- The AcoA aneurysm was successfully treated with surgical clipping.
- Post-intervention, the patient experienced a gradual recovery from bilateral abducens nerve paralyses.
- Complete resolution of the nerve palsy was observed within 3 months post-surgery.
Implications:
- This case highlights that bilateral abducens nerve paralysis can be a rare but distinct consequence of ruptured AcoA aneurysms and SAH.
- Neurosurgeons and neurologists should maintain a high index of suspicion for this specific complication in patients with AcoA aneurysm rupture.
- Early diagnosis and appropriate management of the aneurysm are crucial for favorable outcomes, including the recovery of cranial nerve function.