Rationale:
Bilateral abducens nerve deficits caused by vertebral artery (VA) aneurysm have been reported, but there have been no reports regarding accompanying urinary retention.
Patient concerns:
In this report, we describe an unusual case with bilateral abducens nerve palsy and urinary retention due to rupture of a vertebral aneurysm.
Diagnoses:
Subarachnoid hemorrhage caused by the rupture of a left VA aneurysm.
Interventions:
The VA aneurysm was successfully controlled by coil embolization.
Outcomes:
Urinary retention was improved after embolization and recovered by the day the patient left hospital. The bilateral abducens nerve palsy gradually recovered 6 months later.
Lessons:
This case emphasizes the importance of maintaining a broad, open mind in approaching the diagnosis and management of urinary retention associated with cranial nerve symptoms and reacting quickly to the clinical developments.