Nakanishi K, Akai F, Taneda M, Nakao Y
Department of Neurosurgery, Kinki University School of Medicine, Osaka, Japan.
No Shinkei Geka. 1999 Jan;27(1):19-23.
Several pathological conditions are responsible for abducens palsy, but a lesion of the vertebral artery (VA) has rarely been recognized as one of the causes. It has been reported that a high percentage of cases of abducens palsy are involved with ruptured dissecting aneurysms of the VA. We investigate the vertebrobasilar anatomy in 4 patients, suffering with abducens palsy. One patient revealed a fusiform dilatation of the vertebral artery on the same side as the abducens palsy. Three patients were noted to have stenosis of the vertebral artery from the origin of the posterior inferior cerebellar artery (PICA) to the union. Finally, four patients were found to have abnormal vertebrobasilar anatomy, which was on the same side as the abducens palsy. It is conceivable that changes of vertebrobasilar circulation may cause abducens palsy through direct compression, or ischemic events.
多种病理状况可导致展神经麻痹，但椎动脉（VA）病变很少被认为是病因之一。据报道，展神经麻痹病例中有很大比例与椎动脉夹层动脉瘤破裂有关。我们对4例患有展神经麻痹的患者的椎基底动脉解剖结构进行了研究。1例患者在与展神经麻痹同侧的椎动脉出现梭形扩张。3例患者被发现从后下小脑动脉（PICA）起始处到汇合处的椎动脉存在狭窄。最后，4例患者均被发现椎基底动脉解剖结构异常，且与展神经麻痹在同一侧。可以想象，椎基底动脉循环的改变可能通过直接压迫或缺血事件导致展神经麻痹。
