Background: Isolated abducens nerve palsy can be the presenting sign of a ruptured PICA aneurysm. Few cases have been reported in the literature. In the majority of cases, cranial nerve VI resolved following microsurgical clipping.
Case description: Here, we report a 56-year-old female who presented with a ruptured 4 mm × 3 mm left PICA aneurysm associated with a left abducens nerve palsy. The patient underwent endovascular coil embolization of the aneurysm and had complete resolution of her abducens nerve palsy.
Conclusions: Here, we present the first case of an abducens nerve palsy associated with a ruptured PICA aneurysm to completely resolve following endovascular coil embolization. The direction and amount of subarachnoid hemorrhage extravasation from the ruptured aneurysm are most likely responsible for cranial nerve palsy.
Keywords: CN VI palsy; PICA aneurysm; Subarachnoid hemorrhage.
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