Bilateral abducens paralysis following head injury: a case report

Cranial nerve lesions often accompany head trauma. Olfactory, facial and vestibular nerves are the most commonly injured nerves. Optic and oculomotor nerve injuries are less frequently involved, and trigeminal, abducens and lower cranial nerves are rarely involved. The injury may occur in central nervous system or in the lower motor unit. Traumatic bilateral abducens paralysis is a very rare occurrence. It may follows cervical spine trauma and sixth nerve avulsion has been reported to complicate lumbar puncture. In this study, we describe an 11-year-old boy with bilateral abducens paralysis following hematoma in the left ponto-cerebellar angle and hemorrhage in the prepontine cisterns due to head trauma. Such hemorrhages might result in lesions in the supranuclear regions by traction on the nerve due to displacement of the pons and its nucleus as a result of direct pressure. (J Pediatr Neurol 2003; 1(2): 107-109).