Abducens nerve palsy in a patient with a parasagittal meningioma--case report

A 67-year-old female presented with isolated unilateral abducens nerve palsy progressing in 10 days. There were no signs of elevated intracranial pressure. Magnetic resonance imaging revealed a right parasagittal meningioma. The tumor was grossly totally removed and the patient's nerve palsy gradually improved within 3 weeks. The mechanism of the isolated abducens nerve palsy in this case is attributed to compression of the abducens nerve by entrapment of the cerebrospinal fluid just before entering Dorello's canal under the petrolingual ligament. Linear forces in the midsagittal plane due to the mass effect of the tumor may have temporarily increased the local cerebrospinal fluid pressure and caused 'pseudoentrapment' of the abducens nerve.