Özet:

We present a case of bilateral sixth nerve paralysis due to bilateral middle cerebral artery aneurysms.A46-yearold woman with severe headache, nausea and diplopia which had started six days before her admittance was found unconsious at home and admitted to our emergency unit. On neurological examination she was alert and had nuchal rigidity. There was no papil oedema but right subhyaloid hemorrhage in fundoscopy and bilateral abducens nerve paralysis. Although cranial magnetic resonance images (MRI) showed no neuropathology, cerebrospinal fluid (CSF) was xanthochromic. The emergency digital substraction angiography (DSA) demonstrated a 7mm at the right and 10mm at the left sacculer aneurysms of middle cerebral arteries. After successful clipping of aneursyms bilateral abducens nerve palsies resolved. Subarachnoid hemorrhage should be considered in differential diagnosis of abducens nerve paralysis.

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