Abducens Nerve Pareses Associated with Aneurysmal Subarachnoid Hemorrhage

Munakata, Akira; Ohkuma, Hiroki; Nakano, Takahiro; Shimamura, Norihito

doi:10.1159/000110421

Cited by 17 publications

(19 citation statements)

References 18 publications

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“…The authors found the size of the prepontine clot to be the best predictor of the presence of palsy [8]. This argues for a primarily mechanical effect.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Complication of Hypertensive Hemorrhage – Delayed Oculomotor Palsy: Case Report and Literature Review

Dardis

Sharfstein

2011

Case Rep Neurol

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We present a case of oculomotor palsy due to hypertensive hemorrhage in the caudate nucleus, with intraventricular extension. To our knowledge, this is the only instance of this complication occurring due to hypertensive hemorrhage. Our patient initially developed headache at the time of her hemorrhage; 8 days later, she developed complete third nerve palsy, which showed improvement at follow-up 4 months later. This was due to tracking of blood into the perimesencephalic cistern. The presence of hemorrhage in the basal cisterns was not visible on the initial CT scans and highlights the role of MRI in evaluating the brainstem for the presence of blood products.

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“…The authors found the size of the prepontine clot to be the best predictor of the presence of palsy [8]. This argues for a primarily mechanical effect.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Complication of Hypertensive Hemorrhage – Delayed Oculomotor Palsy: Case Report and Literature Review

Dardis

Sharfstein

2011

Case Rep Neurol

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“…Up to 6% (Munakata et al 2007) are associated with sixth nerve palsy and Edgar et al (1992) speculated that direct shock to the brain stem caused by aneurysmal rupture and stretching of structures lying between the brain and the skull in the subarachnoid space were the factors causing abducens nerve pareses. Localised compression of the nerve by a primary pituitary tumour, craniopharyngioma or meningioma in the base of the skull or close to the pituitary fossa or cavernous sinus.…”

Section: Peripheral Damagementioning

confidence: 99%

Neurogenic Palsies

2013

Diagnosis and Management of Ocular Motility Disorders

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“…It has been reported that vascular causes account for 20% of CN3 palsies, for 18.6% of CN4 palsies and for 17.7% of CN6 palsies [6]. Other etiologies such as aneurysm, trauma, neoplasm, brain stem infarction, infection, inflammation, sinus thrombosis and multiple sclerosis have also been proposed [7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

Hoi¹,

Chen²,

Fuh³

et al. 2016

Cerebrovasc Dis

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Background and Purpose: The aim of this nationwide cohort study was to evaluate whether the occurrence of isolated 3rd, 4th or 6th cranial nerve (CN) palsies is associated with a higher risk of ischemic stroke. Methods: This study utilized data from Taiwan Longitudinal Health Insurance Database during 1995-2012. Subjects aged 20 years or older who had isolated CN 3/4/6 palsies diagnosed by a neurologist or ophthalmologist between January 2000 and December 2011 were included. A set of propensity score matched, randomly sampled patients who had never been diagnosed with CN 3/4/6 palsies were extracted to constitute the control group (cases and controls = 1:4). All subjects were followed until death, loss due to follow-up or completion of the study. Cox proportional hazard regression model stratified by matched pairs was used to estimate the hazards ratio (HR) of ischemic stroke. Results: A total of 657 patients with isolated CN 3/4/6 palsies (61.1% male, mean age 54.8 years) were identified. Compared with control group, the patients with isolated CN 3/4/6 palsies exhibited an increased risk of ischemic stroke (CN3: adjusted HR 3.69 (95% CI 2.20-6.19); CN4: 2.71 (95% CI 1.11-6.64); CN6: 2.15 (95% CI 1.31-3.52)). The association between CN 3/4/6 palsies and ischemic stroke was detected in both separate subgroup and sensitivity analyses. Conclusions: The patients with CN 3/4/6 palsies exhibited an increased risk of developing ischemic stroke. Therefore, isolated ocular motor nerves palsies appear to represent an unrecognized risk factor for ischemic stroke, and these require further confirmation and exploration.

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Abducens Nerve Pareses Associated with Aneurysmal Subarachnoid Hemorrhage

Cited by 17 publications

References 18 publications

An Unusual Complication of Hypertensive Hemorrhage – Delayed Oculomotor Palsy: Case Report and Literature Review

An Unusual Complication of Hypertensive Hemorrhage – Delayed Oculomotor Palsy: Case Report and Literature Review

Neurogenic Palsies

Increased Risk of Stroke in Patients with Isolated Third, Fourth, or Sixth Cranial Nerve Palsies: A Nationwide Cohort Study

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