Kimura Seigo, Yagi Ryokichi, Yamada Keiichi, Taniguchi Hirokatsu, Wanibuchi Masahiko
Department of Neurosurgery, Kouzenkai Yagi Neurosurgical Hospital, Osaka, JPN.
Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, JPN.
Cureus. 2022 Nov 22;14(11):e31797. doi: 10.7759/cureus.31797. eCollection 2022 Nov.
The presentation of abducens nerve palsy after each occurrence of subarachnoid hemorrhage (SAH) is rare. Herein, we report the case of a patient with a ruptured microaneurysm at the tip of the basilar artery who presented with right abducens nerve palsy at the time of the initial rupture and rerupture during an outpatient follow-up. A 52-year-old woman developed SAH with right abducens nerve palsy, which was treated with coil embolization. One year after the initial SAH, there was a relapse of the SAH and paresis of the right abducent nerve palsy. This may have been caused by the location of the abducens nerve in relation to the surrounding structures, which were susceptible to the effects of hematoma or intracranial pressure fluctuations. Stent-assisted coil embolization is an effective treatment for regrowth that appears after endovascular therapy of microaneurysms.
每次蛛网膜下腔出血（SAH）后出现外展神经麻痹的情况较为罕见。在此，我们报告一例基底动脉顶端微小动脉瘤破裂的患者，该患者在初次破裂时以及门诊随访期间再次破裂时均出现右侧外展神经麻痹。一名52岁女性发生SAH并伴有右侧外展神经麻痹，接受了弹簧圈栓塞治疗。初次SAH后一年，SAH复发且右侧外展神经麻痹加重。这可能是由于外展神经相对于周围结构的位置关系，使其易受血肿或颅内压波动的影响。支架辅助弹簧圈栓塞是治疗微小动脉瘤血管内治疗后出现的再生长的有效方法。
