外伤性微小动静脉瘘导致的孤立性双侧展神经麻痹
Isolated bilateral abducens nerves palsy due to traumatic delicate arteriovenous fistula.
作者信息
Chang Jae Hyeok, Shin Yong Beom, Sohn Hyun Joo, Ko Hyun-Yoon, Lee Tae Hong, Ha Yong Hoon
机构信息
Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Seo-gu, Busan, Republic of Korea.
出版信息
Brain Inj. 2010 Jan;24(1):46-9. doi: 10.3109/02699050903409854.
BACKGROUND
Ocular motor dysfunction is common in patients with head trauma. Also, traumatic lateral gaze palsy is usually associated with brain stem lesion, peripheral nerve injury with or without basilar skull fracture and lateral rectus muscle injury or entrapment. However, isolated bilateral abducens nerve palsy is extremely rare.
CASE STUDY
This study describes a case of isolated bilateral abducens nerve palsy in a 35-year-old male with head trauma without cervical and skull fractures. He was diagnosed with mild diffuse axonal injury. During his assessment, he developed mild limb weakness, an ataxic gait and impaired abductive movement in both eyes. Angiography of the left common carotid artery revealed multiple small arteriovenous fistulae in both inferior nasal conchae. After embolization, lateral gaze palsy of his eyes was significantly improved.
CONCLUSIONS
Based on this case, arteriovenous fistula should be considered as a cause of bilateral isolated abducens nerve palsy.
背景
眼球运动功能障碍在头部外伤患者中很常见。此外，外伤性外展凝视麻痹通常与脑干病变、伴或不伴颅底骨折的周围神经损伤以及外直肌损伤或嵌顿有关。然而，孤立性双侧展神经麻痹极为罕见。
病例研究
本研究描述了一名35岁男性头部外伤后出现孤立性双侧展神经麻痹的病例，该患者无颈椎和颅骨骨折。他被诊断为轻度弥漫性轴索损伤。在评估过程中，他出现了轻度肢体无力、共济失调步态以及双眼外展运动受损。左颈总动脉血管造影显示双侧下鼻甲有多个小动静脉瘘。栓塞治疗后，他的眼球外展凝视麻痹明显改善。
结论
基于该病例，动静脉瘘应被视为双侧孤立性展神经麻痹的一个病因。
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