Bilateral sixth nerve palsy after head trauma Ranjiv M. Advani, MD, Michael R. Baumann, MD  Annals of Emergency Medicine  Volume 41, Issue 1, Pages 27-31 (January 2003) DOI: 10.1067/mem.2003.46 Copyright © 2003 American College of Emergency Physicians Terms and Conditions

Figure 1 A, Looking straight; B, looking right; C, looking left. Annals of Emergency Medicine 2003 41, 27-31DOI: (10.1067/mem.2003.46) Copyright © 2003 American College of Emergency Physicians Terms and Conditions

Figure 2 Schematic diagram of the course of the sixth cranial nerve from the pons (A) to the lateral rectus muscle (F). The nerve ascends over the petrous bone (D) and under Gruber’s ligament (E) as it passes through Dorello’s canal (C). The nerve is tethered by dura before and after the canal (stars). Injury to the peripheral nerve is thought to occur by contusion against the petrous ridge after midfrontal head impact. B, Posterior clinoidal process; G, globe. Annals of Emergency Medicine 2003 41, 27-31DOI: (10.1067/mem.2003.46) Copyright © 2003 American College of Emergency Physicians Terms and Conditions