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e-ISSN: 2254-6189

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Year 2019 / Volume 26 / Number 6

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Letter to the Editor

Abducens nerve palsy associated with dural puncture and neurovascular compression

Rev. Soc. Esp. Dolor. 2019; 26(6): 376-378 / DOI: 10.20986/resed.2019.3722/2018

María Beatriz Perdomo Perdomo, Samuel Hernández González, Vicente Martín García, Elisabeth María Carrillo González, Elena Espinosa Domínguez

ABSTRACT

We present the case of a 59 years old man, who is diagnosed with a right sixth cranial nerve palsy, after the development of a dural post-puncture headache, secondary to an accidental dural puncture during an epidural. In magnetic resonance imaging, a compromise of the basilar artery space appears on the emergence of the right sixth cranial nerve. Possibly, this vascular anatomical variant, predisposed him to a greater vulnerability of the abducens nerve. The traction of the nerve could cause a neural ischemia, so intracranial hypotension could be the trigger of the palsy. He recovered completely with conservative treatment.

RESUMEN

Presentamos el caso de un varón de 59 años, que cursa con un cuadro de parálisis del VI par craneal derecho, tras una cefalea postpunción dural, secundaria a una punción dural accidental durante una epidural. En la resonancia magnética, aparece un compromiso del espacio de la arteria basilar sobre la emergencia del VI par derecho. Posiblemente, esta variante anatómica vascular, lo haya predispuesto a una mayor vulnerabilidad del nervio abducens. La tracción del nervio, pudo producir una isquemia, convirtiendo a la hipotensión licuoral en el posible desencadenante de la parálisis. Con tratamiento conservador se recuperó completamente.

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Perdomo Perdomo M, Hernández González S, Martín García V, Carrillo González E, Espinosa Domínguez E. Abducens nerve palsy associated with dural puncture and neurovascular compression. Rev Soc Esp Dolor 2019; 26(6): 376-378 / DOI: 1020986/resed20193722/2018

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Publication history

Received: 28/12/2018

Accepted: 03/04/2019

Online First: 25/10/2019

Published: 11/12/2019

Article revision time: 72 days

Article Online First time: 301 days

Article editing time: 348 days

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