Ophthalmic segment aneurysmal subarachnoid hemorrhage presenting with contralateral abducens nerve palsy: A false localizing sign
published online 12 July 2010.
Abstract
Background
Neuro-ophthalmic manifestations of aneurysmal subarachnoid hemorrhage are commonly linked to a palsy of the cranial nerve in close proximity to the aneurysm or to chronic intracranial hypertension.
Case Report
A patient with subarachnoid hemorrhage secondary to a rupture of an intracranial right ophthalmic segment internal carotid artery aneurysm presented with an acute-onset contralateral abducens nerve palsy. There were no clinical or radiologic features of chronic intracranial hypertension. Magnetic resonance imaging showed a co-existent ectatic basilar artery on the left side of the pons in close relation to the sixth nerve.
Conclusion
Abducens weakness in the above-50 age group is most commonly caused by a vascular etiology. The authors discuss the pathogenesis of this rare clinical entity and present pertinent literature review.
Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, EPIP Area, Whitefield, Bangalore, Karnataka State, India
Corresponding author: Sunil V. Furtado, M.S., M.Ch., D.N.B., Department of Neurosurgery, SSSIHMS, EPIP Area, Whitefield, Bangalore-560066, India.
Source of support: The authors have not received any support, in the form of grant, from any source for preparation of this article. Neither the authors nor the institute has any personal or institutional financial interest in drugs, materials, or devices described in their submissions.
ABSTRACT