Millard-Gubler Syndrome: A Case Report

Abstract

Rebleeding, cerebral vasospasm, hydrocephalus, seizures, cardiopulmonary complications, hypertension, urinary, and fecal incontinence, electrolyte and fluid imbalance are frequently encountered complications of aneurysm, surgical, and endovascular treatment of aneurysm. Neurological deficits secondary to surgery or endovascular coiling are also among these complications. Millard-Gubler Syndrome develops as a result of injury or infarction of the pons at the level of the facial nerve nucleus.In this syndrome facial nerve nucleus, the abducent nerve, and the opposite corticospinal tract fibers are involved. This report describes a patient presenting with severe headache, and generalized seizure to our intensive care unit. Cranial computed tomography was performed and revealed on subarachnoid hemorrhage. After the aneurysm of the left posterior communicating artery was detected in the radiology department, the patient underwent clipping operation in our department the next day. The patient had no neurological deficits after microsurgical clipping treatment till the third postoperative day when sudden right peripheral facial paralysis and diplopia (double vision) developed which was associated with left side hemiparesis, i.e, the right (opposite side of aneurysm). This right-sided Millard-Gubler Syndrome which has not been cited in the literature so far was reported by us.