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KMID : 0360220180590040388
대한안과학회지
2018년 59권 4호 p.388 ~ p.392
눈분절 속목동맥자루에 의한 가돌림신경마비 1예
Abducens Nerve Palsy Caused by the Ophthalmic Segment of an Internal Carotid Artery Aneurysm
김인혜 ( Kim In-Hye ) - 영남대학교 의과대학 안과학교실

김종훈 ( Kim Jong-Hoon ) - 영남대학교 의과대학 신경외과학교실
김원제 ( Kim Won-Jae ) - 영남대학교 의과대학 안과학교실
- Abstract -
Purpose: To report a case of isolated abducens nerve palsy caused by the ophthalmic segment of an internal carotid artery (ICA) aneurysm which improved after endovascular coil trapping.

Case summary: A 59-year-old female visited the ophthalmology department for a sudden onset of horizontal diplopia for 10 days. The best corrected visual acuity was 20/20 in both eyes. The pupils showed normal response to light and near stimulation in both eyes. The extraocular examination showed 35 prism diopters left esotropia at primary gaze and ?4 abduction limitation of the left eye. The patient suffered intermittent headaches in the left temporal area and left retrobulbar pain for 1 month. Magnetic resonance imaging with magnetic resonance angiography of the brain was performed. A focal protruding lesion of the left ICA suggested an aneurysm. The patient consulted with the neurosurgery department. The left ophthalmic segment of the ICA aneurysm was confirmed by transfemoral cerebral angiography and treated with coil placement and the patient showed gradual improvement after the procedure. Three months after the procedure there was no diplopia. The patient showed orthotropia at primary gaze without abduction limitation.

Conclusions: Isolated abducens nerve palsy can be caused by the ophthalmic segment of an ICA aneurysm, which should be considered in the differential diagnosis of ocular motility disorders. The disorder improved with coil replacement treatment. Differential diagnosis as a cause of abducens nerve palsy is important for prompt and appropriate treatment. Neuroimaging should be considered in patients with isolated abducens nerve palsy with a non-ischemic origin.
- Key Words -

Abducens nerve palsy, Aneurysm, Diplopia, Internal carotid artery
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학술진흥재단(KCI) KoreaMed 대한의학회 회원