Neurovascular compression of the abducent nerve causing abducent palsy treated by microvascular decompression

Case report

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✓Isolated abducent palsy is a symptom that can be caused by many different intracranial pathological conditions. In this report the authors describe the case of a patient who suffered isolated abducent palsy resulting from vascular compression of the sixth cranial nerve; surgical treatment consisted of microvascular decompression (MVD).

This 56-year-old man presented with short-lasting episodes of a pulling sensation at the lateral side of his right eye associated with intermittent diplopia, followed by a progressive palsy of the abducent nerve and constant diplopia. Magnetic resonance imaging revealed a neurovascular contact of a dolichoectatic basilar artery with the abducent nerve. The patient underwent surgery consisting of a combined supra- and infratentorial presigmoid approach and subsequent MVD of the abducent nerve. Postoperatively, the abducent nerve palsy resolved within days, and the patient remains free of symptoms with a follow-up time of 4 years.

This is the first report of a neurovascular compression of the abducent nerve treated successfully by MVD.

Abbreviations used in this paper:BA = basilar artery; CA = carotid artery; CISS = constructive interference in steady state; MR = magnetic resonance; MVD = microvascular decompression.
Article Information

Contributor Notes

Address correspondence to: Dirk de Ridder, M.D., Ph.D., Department of Neurosurgery, University Hospital of Antwerp, Wilrijkstraat 10, 2650 Antwerp, Belgium. email: dirk.de.ridder@uza.be.

© AANS, except where prohibited by US copyright law.

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