LAUSR

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.