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Abducens length and vulnerability?

From the Departments of Neurology (Dr. Hanson), Neurosurgery (Drs. Ghosh and Levy), and Neuropathology (Drs. Gonzalez-Gomez and Gilles), Childrens Hospital of Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA.

Address correspondence and reprint requests to Dr. Floyd H. Gilles, Department of Neuropathology, Childrens Hospital of Los Angeles, 4650 Sunset Boulevard, MS 43, Los Angeles, CA, 90027; e-mail: fgilles{at}chla.usc.edu

Background: Several sources have attributed the vulnerability of the abducens nerve to its long intracranial course. However, other anatomic factors likely contribute to the apparent vulnerability of the abducens nerve to mass lesions and trauma.

Methods: The authors performed a two-part anatomic study of the abducens nerve. In the first part of the study, they compared the length of the abducens with another cranial nerve, the trochlear, at the autopsy of 26 pediatric patients. In the second part of the study, the authors used an endoscopic exposure of these two cranial nerves in a preserved human cadaver head.

Results: The abducens nerve was consistently approximately one-third the length of the trochlear nerve at all ages that they studied. The endoscopic views revealed the structural and vascular relationships of the abducens nerve in situ.

Conclusions: The authors conclude from these findings and the literature that abducens nerve vulnerability results from factors other than its intracranial length.

Received November 1, 2002. Accepted in final form July 18, 2003.

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