Dorello canal revisited

An observation that potentially explains the frequency of abducens nerve injury after head injury

R. Shane Tubbs, Virginia Radcliff, Mohammadali M. Shoja, Robert P. Naftel, Martin M. Mortazavi, Anna Zurada, Marios Loukas, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: The abducens nerve is frequently injured after head trauma and some investigators have attributed this to its long intracranial course. The present study aimed to elucidate an additional mechanism to explain this phenomenon. Methods: Twelve fresh adult cadavers underwent dissection of Dorello canal using standard microsurgical techniques. In addition, traction was applied to the nerve at its entrance into this canal before and after transection of Gruber ligament to observe for movement. Results: In all specimens, a secondary tunnel (i.e., tube within a tube) was found within Dorello canal that exclusively contained the abducens nerve. This structure rigidly fixated the abducens nerve as it traversed Dorello canal, thereby not allowing any movement. Transection of Gruber ligament did not detach the nerve, but after release of the inner tube, the nerve was easily mobilized. Conclusions: Rigid tethering of the abducens nerve with a second tube within Dorello canal affords this nerve no ability for movement with motion of the brainstem. We hypothesize that this finding is a main factor in the high incidence of abducens nerve injury after head trauma.

Original languageEnglish
Pages (from-to)119-121
Number of pages3
JournalWorld Neurosurgery
Volume77
Issue number1
DOIs
StatePublished - Jan 2012

Fingerprint

Abducens Nerve Injury
Abducens Nerve
Craniocerebral Trauma
Observation
Ligaments
Traction
Cadaver
Brain Stem
Dissection
Research Personnel
Incidence

Keywords

  • Abducens nerve
  • Anatomy
  • Cranial nerve
  • Injury
  • Neurosurgery
  • Skull base

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Dorello canal revisited : An observation that potentially explains the frequency of abducens nerve injury after head injury. / Tubbs, R. Shane; Radcliff, Virginia; Shoja, Mohammadali M.; Naftel, Robert P.; Mortazavi, Martin M.; Zurada, Anna; Loukas, Marios; Cohen-Gadol, Aaron.

In: World Neurosurgery, Vol. 77, No. 1, 01.2012, p. 119-121.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Radcliff, Virginia ; Shoja, Mohammadali M. ; Naftel, Robert P. ; Mortazavi, Martin M. ; Zurada, Anna ; Loukas, Marios ; Cohen-Gadol, Aaron. / Dorello canal revisited : An observation that potentially explains the frequency of abducens nerve injury after head injury. In: World Neurosurgery. 2012 ; Vol. 77, No. 1. pp. 119-121.
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