The sixth abducens nerve is subject to injury after rare complications of intracranial hypotension caused by procedures such as dural punctures and spinal surgeries. The purpose of this case report is to discuss the mechanism of nerve palsy in these situations. Therefore, we describe a case of onset of contralateral sixth cranial nerve palsy after intracranial aneurysm and temporal meningioma surgery. Moreover, in this case there is a singularity due to the presence of the petroclival meningioma that amplified the unfolding of the lesion.
O acesso pterional é um dos acessos mais conhecidos em neurocirurgia, sendo utilizado tanto no tratamento de doenças vasculares como patologias da base do crânio, dado a sua versatilidade. A incisão pré-capilar com uma ampliação da craniotomia minipterional, proporciona um campo operatório bem similar. Desta forma, permite realizar cirurgias neurológicas por via pterional, tendo ainda como vantagem, após a reposição do flap ósseo, uma incisão menor, além de pouco ou nenhum déficit, seja funcional, anatômico ou cosmético. Entretanto, são necessários mais estudos para comparar com outras abordagens.
Atlantoaxial rotatory subluxation in association with head and neck infectious process (Grisel’s syndrome) is a rare disease and poorly reported. The syndrome`s pathogenesis is unclear and several theories have been proposed to explain it. This paper report a 7 year old child with Grisel’s syndrome and the literature on this subject is briefly reviewed.
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