Cover Image

Abducens Nerve Paralysis Caused due to Increased Intracranial Pressure: A Case Report and Review of Literatures

Khadijeh Haji Naghi Tehrani, Zahra Morshedian

Background: Double vision due to abducens nerve palsy in patients with Pseudotumor cerebri is a very rare finding and usually occurs by increasing in intracranial pressure (ICP) and therefore by the effect of pressure on abducens nerve. Case Report: A 21-year-old woman has referred to our clinic with symptoms of the headaches, double vision along with nausea and vomiting lasting for three months, with no history of the disease, drug consumption, and the only clinical findings was weighing about 20 Kg for a recent year. In examination VI nerve palsy of the left eye, papilledema of both eyes was reported. The computed tomography (CT) and magnetic resonance imaging (MRI) as a diagnostic test for a patient’s brain lesions shown normal report. Also, other hormone testing and complete blood count were normal. For the next step patient underwent for lumbar puncture (LP), the patient’s cerebrospinal fluid (CSF) pressure was measured more than 120 CmH2O. According to the findings of the examination, patient diagnosed with pseudotumor cerebri and underwent for frequent LP, which during that the headaches and double vision symptoms of patient decreased, which indicates that all signs and symptoms of patients caused by pseudotumor cerebri were due to sudden increase in body weight over the past year. Patient prescribed for Acetazolamide and recommended to lose weight with proper diet. For three months of follow-up, symptoms of increased ICP and papilledema have been cleared. Conclusion: The pseudotumor cerebri is manageable by proper diet, and there is no need for bariatric surgery. [GMJ.2017;6(1):66-69]

Papilledema; Cerebrospinal Fluid; Pseudo-Tumor Cerebri; Lumbar Puncture; Diplopia

Nadkarni T, Rekate HL, Wallace D. Resolution of pseudotumor cerebri after bariatric surgery for related obesity: Case report. J Neurosurg. 2004;101(5):878-80.

Karahalios DG, Rekate HL, Khayata MH, Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology. 1996;46(1):198-202.

Alaud-din A, Meterissian S, Lisbona R, MacLean LD, Forse RA. Assessment of cardiac function in patients who were morbidly obese. Surgery. 1990;108(4):809-18; discussion 818-20.

Sugerman HJ. Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am. 2001 Oct;81(5):1063-75.

Sugerman HJ, DeMaria EJ, Felton WL 3rd, Nakatsuka M, Sismanis A. Increased intra-abdominal pressure and cardiac filling pressures in obesity-associated pseudotumor cerebri. Neurology. 1997;49(2):507-11.

Johnson LN, Krohel GB, Madsen RW, March GA Jr. The role of weight loss and acetazolamide in the treatment of idiopathic intracranial hypertension (pseudotumor cerebri). Ophthalmology. 1998;105(12):2313-7.

Muller A, Krishnan KG, Uhl E, Mast G. The application of rapid prototyping techniques in cranial reconstruction and preoperative planning in neurosurgery. J Craniofac Surg. 2003;14(6):899-914.


  • There are currently no refbacks.