[Traumatic bilateral paralysis of the abducens nerve without cervical fracture]. / Paralysie bilatérale traumatique du nerf abducens sans fracture cervicale.

We report the case of a 75-year-old woman with an uneventful medical history who presented with sudden-onset diplopia immediately after neck trauma in a traffic accident. Clinical and ophthalmological examinations were consistent with bilateral abducens nerve palsy. The causal relationship, including the medicolegal implications and the pathophysiological mechanism are discussed. The case demonstrates that exceptionally benign trauma can cause severe diplopia. The delay to recovery may be very long, suggesting caution concerning the decision of surgical care.

Cerebellar border zone infarcts are often associated with presumed cardiac sources of ischaemic stroke.

It has been suggested that most border zone cerebellar infarcts are embolic infarcts or infarcts due to hypercoagulatble states. The aim of this study was to test this hypothesis. Risk factors for the presumed mechanism of stroke (TOAST criteria) were studied in 14 consecutive patients (nine men, five women; age range 29-84 years) with a total of 17 border zone cerebellar infarcts. The presumed cause of stroke was "cardioembolism" in nine patients. Three patients had a dissection of the vertebral artery. Two patients had a negative diagnostic investigation, and one had a cardiac arrest. These findings support the hypothesis that cardioembolism is a frequent mechanism of border zone cerebellar infarcts.