Intracavernous carotid aneurysm as a rare case of isolated sixth nerve palsy in an eight-year-old child

Abstract

Cerebral aneurysms are rare in childhood. When occurring they usually present with subarachnoid hemorrhage, but may present as a mass lesion with seizures, or as an incidental finding. An isolated sixth nerve palsy as a presenting sign is even more unusual. The authors describe a case of an acquired sixth nerve palsy in an eight-year-old girl due to a fusiform aneurysm of the intracavernous portion of the internal carotid artery. The clinical problem in this child is complex and involves the management philosophy of dealing with the aneurysm itself as well as that of the abduction deficit which has produced a cosmetically and functionally unacceptable head turn to the ipsilateral side.

Key Words:

• Sixth nerve palsy
• childhood
• carotid aneurysm
• cavernous sinus