Crossed Eyes and Halo-Pelvic Traction

Fourth and sixth cranial nerve injury after halo traction in children: A report of two cases

“…5 Palsies of the abducens, glossopharyngeal, vagus, and hypoglossal nerves have all been reported after traction in the neurosurgical and orthopedic literature. [2][3][4][5][6][7][8] However, to the best of our knowledge, trochlear nerve palsy of this etiology has not previously been reported.…”

“…This may lead to localized ischemia and reduced nerve function. 6,7,11 Again, when the causative force is removed and the ischemia subsides, there may be resolution of the neurological deficit. Ginsberg and Bassett 3 described a case of hypoglossal nerve palsy after halo traction that they treated with corticosteroids to reduce the possibility of nerve compression due to edema.…”

“…However, more serious neurological injury, such as cranial nerve palsy, also may occur. [2][3][4][5][6][7][8] We report 2 cases of combined fourth and sixth nerve palsies that follow a period of cervical spinal halo traction in children. To the best of our knowledge, fourth nerve palsy has not previously been reported as a complication of spinal traction.…”

Arterial supply of the upper cranial nerves: A comprehensive review

“…Trochlear or abducens nerve palsies caused by vascular pathologies outside of the cavernous sinus are rare. Halo traction has been found to pose a risk for both abducens and trochlear nerve palsies in children (Telfer et al, ; Barsoum et al, ). While the underlying pathology is less clear, vascular compromise may serve as a plausible explanation (Pinches et al, ).…”