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

Year 2016, Volume: 3 Issue: 9, 334 - 8, 15.09.2016

Ferhat Cuce Cem Ozgonul Ahmet Eroglu , Ozgur Bulent Oztimucin Samet Verim

https://doi.org/10.17546/msd.88261

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

Abducens Palsy Aneurysm Dorello’s Canal; MRI; Trauma

References

  • 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.
  • Durkin SR, Tennekoon S, Kleinschmidt A, Casson RJ, Selva D, Crompton JL. Bilateral sixth nerve palsy. Ophthalmology. 2006; 113;2108-2109.
  • Berlit P, Reinhardt-Eckstein J, Krause KH. Isolated abducens paralysis-a retrospective study of 165 patients. Fortschr Neurol Psychiatr 1989; 57;32–40.
  • Raveenthiran V, Reshma KB. Sixth cranial nerve palsy due to arachnoid cyst. J Pediatr Ophthalmol Strabismus 2014;51;58–61.
  • 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.
  • 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.
  • De Ridder D. The abducens nerve and skull base surgery. World Neurosurg 2012; 77;53–54.
  • Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, controversies in microsurgical anatomy, and clinical implications. Neurosurg Focus 2013;34:E4.
  • Ezer H, Banerjee AD, Thakur JD, Nanda A. Dorello's canal for laymen: A lego-like presentation. J Neurol Surg B Skull Base 2012;73:183–189.
  • Sam B, Ozveren MF Akdemir I, Topsakal C Cobanoglu B, Baydar CL, et al. The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study. Forensic Sci Int 2004;140:25–32.
  • Koskela E, Laakso A, Kivisaari R, Setälä K, Hijazy F, Hernesniemi J. Eye movement abnormalities after a ruptured ıntracranial aneurysm. World Neurosurg 2014 Apr 19, Epub ahead of print
  • Caroli M, Bertani G, Fetoni V, Sasanelli F, Gaini SM, Samis Zella MA. Bilateral intracavernous carotid artery aneurysms presenting as abducens nerve palsy: case report. J Neurosurg Sci 2009;53;169–170.
  • Held P, Nitz W, Seitz J, Fründ R, Müller HM, Haffke T et al. Comparison of 2D and 3D MRI of the optic and oculomotor nerve anatomy. Clin Imaging 2000; 24;337–343.
  • Ogawa K, Tougou M, Oishi M, Kamei S, Mizutani T. Case of pontine infarction causing alternating hemiplegia with ipsilateral abducens nerve palsyand contralateral supranuclear facial nerve palsy. Rinsho Shinkeigaku 2008;48;135–138.
  • Rose JW, Digre KB, Lynch SG, Harnsberger RH. Acute VIth cranial nerve dysfunction in multiple sclerosis. Evaluation by magnetic resonance imaging. J Clin Neuroophthalmol 1992;12;17–20.
  • Moy WL, Ooi ST. Abducens nerve palsy and meningitis by Rickettsia typhi. Am J Trop Med Hyg 2014;92; 620–624.

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

Year 2016, Volume: 3 Issue: 9, 334 - 8, 15.09.2016

Ferhat Cuce Cem Ozgonul Ahmet Eroglu , Ozgur Bulent Oztimucin Samet Verim

https://doi.org/10.17546/msd.88261

Abstract

References

  • 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.
  • Durkin SR, Tennekoon S, Kleinschmidt A, Casson RJ, Selva D, Crompton JL. Bilateral sixth nerve palsy. Ophthalmology. 2006; 113;2108-2109.
  • Berlit P, Reinhardt-Eckstein J, Krause KH. Isolated abducens paralysis-a retrospective study of 165 patients. Fortschr Neurol Psychiatr 1989; 57;32–40.
  • Raveenthiran V, Reshma KB. Sixth cranial nerve palsy due to arachnoid cyst. J Pediatr Ophthalmol Strabismus 2014;51;58–61.
  • 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.
  • 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.
  • De Ridder D. The abducens nerve and skull base surgery. World Neurosurg 2012; 77;53–54.
  • Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, controversies in microsurgical anatomy, and clinical implications. Neurosurg Focus 2013;34:E4.
  • Ezer H, Banerjee AD, Thakur JD, Nanda A. Dorello's canal for laymen: A lego-like presentation. J Neurol Surg B Skull Base 2012;73:183–189.
  • Sam B, Ozveren MF Akdemir I, Topsakal C Cobanoglu B, Baydar CL, et al. The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study. Forensic Sci Int 2004;140:25–32.
  • Koskela E, Laakso A, Kivisaari R, Setälä K, Hijazy F, Hernesniemi J. Eye movement abnormalities after a ruptured ıntracranial aneurysm. World Neurosurg 2014 Apr 19, Epub ahead of print
  • Caroli M, Bertani G, Fetoni V, Sasanelli F, Gaini SM, Samis Zella MA. Bilateral intracavernous carotid artery aneurysms presenting as abducens nerve palsy: case report. J Neurosurg Sci 2009;53;169–170.
  • Held P, Nitz W, Seitz J, Fründ R, Müller HM, Haffke T et al. Comparison of 2D and 3D MRI of the optic and oculomotor nerve anatomy. Clin Imaging 2000; 24;337–343.
  • Ogawa K, Tougou M, Oishi M, Kamei S, Mizutani T. Case of pontine infarction causing alternating hemiplegia with ipsilateral abducens nerve palsyand contralateral supranuclear facial nerve palsy. Rinsho Shinkeigaku 2008;48;135–138.
  • Rose JW, Digre KB, Lynch SG, Harnsberger RH. Acute VIth cranial nerve dysfunction in multiple sclerosis. Evaluation by magnetic resonance imaging. J Clin Neuroophthalmol 1992;12;17–20.
  • Moy WL, Ooi ST. Abducens nerve palsy and meningitis by Rickettsia typhi. Am J Trop Med Hyg 2014;92; 620–624.
There are 16 citations in total.

Details

Journal Section Case Reports
Authors

Ferhat Cuce This is me

Cem Ozgonul This is me

Ahmet Eroglu

Ozgur Bulent Oztimucin This is me

Samet Verim This is me

Publication Date September 15, 2016
Published in Issue Year 2016 Volume: 3 Issue: 9

Cite

APA Cuce, F., Ozgonul, C., Eroglu, A., Oztimucin, O. B., et al. (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 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. September 2016;3(9):334-8. doi:10.17546/msd.88261
Chicago Cuce, Ferhat, Cem Ozgonul, Ahmet Eroglu, Ozgur Bulent Oztimucin, and Samet Verim. “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, no. 9 (September 2016): 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 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, 2016, doi: 10.17546/msd.88261.
ISNAD 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 3/9 (September 2016), 334-8. https://doi.org/10.17546/msd.88261.
JAMA 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, 2016, pp. 334-8, doi:10.17546/msd.88261.
Vancouver 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.
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