Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report

Volume: 3 Number: 9 September 15, 2016
  • Ferhat Cuce
  • Cem Ozgonul
  • Ahmet Eroglu
  • Ozgur Bulent Oztimucin
  • Samet Verim
EN TR

Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report

Abstract

Objective: Abducens nerve palsy (ANP) has an incidence of 11.3/100,000. ANP related to pressure of the aneurysm on the Dorello’s canal is unusual. We report a case of bilateral ANP following head trauma.

Case: A 31-year-old woman was admitted for the evalu­ation of diplopia began after trauma.  In the diagnostic imaging; the magnetic resonance imaging (MRI) revealed the normal course of bilateral abducens nerve (AN) in the pontine cistern. The adjacent anatomy of the right AN from pons up to the oculer bulb was normal.  But the distal part of the left ICA petrous segment at the level of foramen lacerum had a remarkable loss of signal void. Multidetector computed tomography  angiogram demonstrated a left distal petrous ICA aneurysm which was under the Dorello’s canal and remodeling the clivus.

Conclusion: We estimated the left ANP was caused by the pressure of the aneurysm. And the right ANP was probably due to the trauma  the patient had experienced.

Keywords

References

  1. Tubbs RS, Radcliff V, Shoja MM, Naftel RP, Mortazavi MM, Zurada A. Dorello canal revisited: an observation that potentially explains the frequency of abducens nerve injury after head injury. World Neurosurg 2012; 77;119–121.
  2. Durkin SR, Tennekoon S, Kleinschmidt A, Casson RJ, Selva D, Crompton JL. Bilateral sixth nerve palsy. Ophthalmology. 2006; 113;2108-2109.
  3. Berlit P, Reinhardt-Eckstein J, Krause KH. Isolated abducens paralysis-a retrospective study of 165 patients. Fortschr Neurol Psychiatr 1989; 57;32–40.
  4. Raveenthiran V, Reshma KB. Sixth cranial nerve palsy due to arachnoid cyst. J Pediatr Ophthalmol Strabismus 2014;51;58–61.
  5. Reyes KB, Lee HY, Ng I, Goh KY. Abducens (sixth) nerve palsy presenting as a rare case of isolated brainstem metastasis from a primary breast carcinoma. Singapore Med J 2011;52;220–222.
  6. Palacios E, Gómez J, Alvernia JE, Jacob C. Aneurysm of the petrous portion of the internal carotid artery at the foramen lacerum: anatomic, imaging, and otologic findings. Ear Nose Throat J 2010;89;303–305.
  7. De Ridder D. The abducens nerve and skull base surgery. World Neurosurg 2012; 77;53–54.
  8. Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, controversies in microsurgical anatomy, and clinical implications. Neurosurg Focus 2013;34:E4.

Details

Primary Language

English

Subjects

-

Journal Section

-

Authors

Ferhat Cuce This is me

Cem Ozgonul This is me

Ozgur Bulent Oztimucin This is me

Samet Verim This is me

Publication Date

September 15, 2016

Submission Date

June 25, 2016

Acceptance Date

-

Published in Issue

Year 2016 Volume: 3 Number: 9

APA
Cuce, F., Ozgonul, C., Eroglu, A., Oztimucin, O. B., & Verim, S. (2016). Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report. Medical Science and Discovery, 3(9), 334-8. https://doi.org/10.17546/msd.88261
AMA
1.Cuce F, Ozgonul C, Eroglu A, Oztimucin OB, Verim S. Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report. Med Sci Discov. 2016;3(9):334-8. doi:10.17546/msd.88261
Chicago
Cuce, Ferhat, Cem Ozgonul, Ahmet Eroglu, Ozgur Bulent Oztimucin, and Samet Verim. 2016. “Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient With Bilateral Abducens Nerve Palsy: Case Report”. Medical Science and Discovery 3 (9): 334-8. https://doi.org/10.17546/msd.88261.
EndNote
Cuce F, Ozgonul C, Eroglu A, Oztimucin OB, Verim S (September 1, 2016) Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report. Medical Science and Discovery 3 9 334–8.
IEEE
[1]F. Cuce, C. Ozgonul, A. Eroglu, O. B. Oztimucin, and S. Verim, “Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report”, Med Sci Discov, vol. 3, no. 9, pp. 334–8, Sept. 2016, doi: 10.17546/msd.88261.
ISNAD
Cuce, Ferhat - Ozgonul, Cem - Eroglu, Ahmet - Oztimucin, Ozgur Bulent - Verim, Samet. “Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient With Bilateral Abducens Nerve Palsy: Case Report”. Medical Science and Discovery 3/9 (September 1, 2016): 334-8. https://doi.org/10.17546/msd.88261.
JAMA
1.Cuce F, Ozgonul C, Eroglu A, Oztimucin OB, Verim S. Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report. Med Sci Discov. 2016;3:334–8.
MLA
Cuce, Ferhat, et al. “Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient With Bilateral Abducens Nerve Palsy: Case Report”. Medical Science and Discovery, vol. 3, no. 9, Sept. 2016, pp. 334-8, doi:10.17546/msd.88261.
Vancouver
1.Ferhat Cuce, Cem Ozgonul, Ahmet Eroglu, Ozgur Bulent Oztimucin, Samet Verim. Aneurysm of the Internal Carotid Artery Pressing on Dorello’s Canal in a Patient with Bilateral Abducens Nerve Palsy: Case Report. Med Sci Discov. 2016 Sep. 1;3(9):334-8. doi:10.17546/msd.88261