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Published on: September 20, 2024
Delayed post-traumatic bilateral abducens nerve palsy with complete recovery
Vijay Yanamadala1, Brian P Walcott, Brian V Nahed
1Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02115, United States.
Summary
Isolated bilateral abducens nerve palsy after head trauma is rare, especially without fractures. Most patients fully recover, highlighting the importance of conservative management and patient counseling for traumatic sixth nerve palsies.
Area of Science:
- Neurology
- Ophthalmology
- Trauma Surgery
Background:
- Isolated bilateral abducens (sixth) nerve palsy is an uncommon presentation following head trauma.
- Previous reports typically involve patients with cranial fractures or acute intracranial pathologies like hemorrhage.
Observation:
- A case study of a 41-year-old man with acute head trauma is presented.
- The patient exhibited isolated bilateral abducens nerve palsy.
- Crucially, there was no evidence of cranial fractures or other acute intracranial pathology.
Findings:
- The patient experienced a full recovery of bilateral abducens nerve function six months post-injury.
- Extraocular muscle movements were intact upon recovery.
- This case supports the generally favorable prognosis for traumatic abducens nerve palsies.
Implications:
- The natural history of traumatic abducens nerve palsy often involves complete functional recovery.
- This underscores the importance of considering conservative management strategies.
- Accurate patient counseling regarding prognosis is essential for managing expectations after head trauma.
