De Ridder Dirk, Menovsky Tomas
Department of Neurosurgery, University Hospital of Antwerp, Belgium.
J Neurosurg. 2007 Dec;107(6):1231-4. doi: 10.3171/JNS-07/12/1231.
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.
孤立性展神经麻痹是一种可由多种不同颅内病理状况引起的症状。在本报告中，作者描述了一例因第六颅神经血管受压导致孤立性展神经麻痹的患者病例；手术治疗包括微血管减压术（MVD）。这位56岁男性患者出现右眼外侧短暂的牵拉感发作，并伴有间歇性复视，随后展神经逐渐麻痹且复视持续存在。磁共振成像显示一条迂曲扩张的基底动脉与展神经存在神经血管接触。该患者接受了由幕上和幕下乙状窦前联合入路及随后展神经微血管减压术组成的手术。术后，展神经麻痹在数天内得到缓解，患者在4年的随访期内一直无症状。这是首例通过微血管减压术成功治疗展神经神经血管压迫的报告。
