Isolated Abducens Nerve Avulsion at Pontomedullary Sulcus following Trivial Head Injury

Abstract

Abducens nerve palsy is commonly seen in neurosurgical practice. However, the abducens nerve palsy secondary to an avulsion injury is extremely rare. The patients present clinically with diplopia and show lateral rectus palsy. Here, the authors present a case report of such an unusual condition following a trivial trauma presenting clinically with left lateral rectus palsy. The course of the nerve and a possible mechanism of such an injury and management are discussed. To the authors knowledge, there is no reported case of an isolated unilateral avulsion injury of the abducens nerve following trauma before this report.

Keywords

abducens nerve - sixth cranial nerve palsy - avulsion injury - lateral rectus palsy

• References

• 1 Patel SV, Mutyala S, Leske DA, Hodge DO, Holmes JM. Incidence, associations, and evaluation of sixth nerve palsy using a population-based method. Ophthalmology 2004; 111 (2) 369-375
• 2 Kumar N, Mukherjee S, Patel MP , Suni, Abhishek, Bhangale D. Delayed manifestation of unilateral 6th and 7th cranial nerve palsies following head injury. Indian J Basic Applied Med Res 2013; 2 (8) 1035-1037
• 3 Sam B, Ozveren MF, Akdemir I , et al. The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study. Forensic Sci Int 2004; 140 (1) 25-32
• 4 Katsuno M, Yokota H, Yamamoto Y, Teramoto A. Bilateral traumatic abducens nerve palsy associated with skull base fracture—case report. Neurol Med Chir (Tokyo) 2007; 47 (7) 307-309
• 5 Hollis GJ. Sixth cranial nerve palsy following closed head injury in a child. J Accid Emerg Med 1997; 14 (3) 172-175