Sri Gautham Bodduluri, Suhas Prabhakar, Anandhalakshmi M, Mary Thomas

Purpose: Abducens nerve palsy can be due to Peripheral lesions like Tumors & Aneurysms involving the basilar artery which is rarely seen. Here we report a rare case of a 37year old female patient who presented with complaints of headache on and off since 10 days with diplopia for distant vision.

Methods: On Slit lamp examination , Anterior segment was normal, Pupils were round reacting to light in both eyes ,no RAPD was seen. Intraocular pressure was 18mmhg in right eye and 16mmhg in left eye .fundus examination was normal. Extraocular movements showed restriction in abduction in both eyes. On CT Brain, a basilar trunk giant fusosaccular aneurysm was noted the basilar aneurysm sac was measuring 3.9×3.4cms. following which Long LEO+ Stent placement surgery was done, after which restriction has improved.

Results: In this case Imaging helped in diagnosing the cause of sixth nerve palsy and patient was referred to departments of Radiology and Neurology for further treatment.

Conclusion: This case highlights the rare possibility of bilateral sixth nerve palsy occurring due to a basilar trunk fusosaccular aneurysm.