Isolated Compressive Sixth Nerve Palsy due to Multiple Intracranial Cavernomas.

Area of Science:

• Neurology
• Neurovascular Medicine
• Vascular Malformations

Background:

• Cavernomas (cerebral cavernous malformations) are prevalent intracranial vascular anomalies, comprising 8-15% of brain and spinal vascular malformations.
• Hemorrhage from cavernomas is a documented cause of neurological deficits, including cranial nerve palsies.

Observation:

• A rare case of multiple intracranial cavernomas affecting both the brain and brainstem (pons) is presented.
• The patient presented with an isolated sixth nerve palsy, a less commonly reported symptom associated with cavernomas.

Findings:

• The study details a unique presentation where multiple cavernomas, rather than hemorrhage, caused direct compression leading to sixth nerve palsy.
• This finding expands the known clinical manifestations of cavernomas.

Implications:

• Highlights the importance of considering compressive effects of cavernomas, not solely hemorrhage, in the etiology of cranial nerve palsies.
• Suggests further investigation into the mechanisms by which cavernomas induce neurological deficits through mass effect.