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Case report
Sixth cranial nerve palsy secondary to compression by dolichoectatic vertebrobasilar artery
  1. Trishal Jeeva-Patel1,
  2. Edward A Margolin1 and
  3. Daniel Mandell2
  1. 1Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  2. 2Medical Imaging, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Edward A Margolin; edmargolin{at}


Dolichoectasia refers to distinct elongation, dilatation and tortuosity of an artery. We present a rare well-illustrated case of dolichoectatic vertebrobasilar artery compressing the cisternal portion of the sixth cranial nerve resulting in chronic sixth nerve palsy. High spatial resolution, three-dimensional, heavily T2-weighted MRI sequences are uniquely positioned to assess the cranial nerves especially in their cisternal and canalicular portions and need to be performed for all patients with non-resolving cranial nerve palsies. Dolichoectatic vessels can be the cause of neurovascular conflict and cause non-resolving oculomotor palsies.

  • visual pathway
  • neuroopthalmology
  • cranial nerves

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  • Contributors EAM: planning, conception and design, acquisition of data or analysis and interpretation of data, manuscript writing and revision. TJ-P: planning, conception and design, manuscript writing and revision. DM: acquisition of data or analysis and interpretation of data, manuscript revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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