A patient is admitted in ICU due to increased intracranial pressure from secondary metastases. He developed left sided sixth nerve palsy. It would lead to:
High-Yield Explanation
Unilateral or bilateral abducens palsy is a classic sign of raised intracranial pressure. The sixth cranial nerve innervates the lateral rectus muscle. A palsy produces horizontal diplopia, worse on gaze to the side of the lesion. An abducens nuclear lesion produces a complete lateral gaze palsy from weakness of both the ipsilateral lateral rectus and the contralateral medial rectus. Ref: Hoon J.C. (2012). Chapter 28. Disorders of the Eye. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.