Ocular Movement Nerve Palsy After Mild Head Trauma

Li, Guichen; Zhu, Xiaodong; Gu, Xiuhong; Sun, Yang; Gao, Xianfeng; Zhang, Yang; Hou, Kun

doi:10.1016/j.wneu.2016.06.133

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…[5][6][7][8]32 Topographically, the oculomotor nerve crosses the pPCL, and at this point it is thought to be susceptible to damage as the brainstem moves downward. 6,8,[32][33][34][35] In such cases, the pPCL acts as a fulcrum, thus focally stretching the fascicules of the oculomotor nerve. Contusion against the pPCL may explain the mechanism of oculomotor nerve palsy seen even after minor head trauma without identifiable lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Contusion against the pPCL may explain the mechanism of oculomotor nerve palsy seen even after minor head trauma without identifiable lesions. [32][33][34][35] This may also lead to tearing of the pupillomotor fibers located on the ventromedial surface of the oculomotor nerve. 6,8,32 In the event of calcification or ossification of the pPCL, the dural sheath of the oculomotor nerve may be fixed much more than usual that may potentially result in greater susceptibility of the nerve to injury.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Wysiadecki

Haładaj

Polguj

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Wysiadecki

Haładaj

Polguj

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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“…Most patients recover completely over a time course of 10 days to 2 months after onset. 11) Our case showed a more protracted clinical course. The MRI also helps us predict the likelihood of recovery from trochlear nerve palsy, as long as the course of the nerve is intact.…”

Section: Discussionmentioning

confidence: 53%

“…Trochlear nerve palsy is an infrequent finding in the case of cranial nerve injuries after minor head trauma. 5 11 14) It can result from trauma because of its close proximity to the tentorial incisura and the long course of the nerve in the subarachnoid space. 5 6 14) The trochlear nerve palsy results in diplopia, which is secondary to the vertical and horizontal deviation, and occasional torsional difficulty.…”

Section: Introductionmentioning

confidence: 99%

Delayed Trochlear Nerve Palsy Following Traumatic Subarachnoid Hemorrhage: Usefulness of High-Resolution Three Dimensional Magnetic Resonance Imaging and Unusual Course of the Nerve

Yang

Son

et al. 2018

Korean J Neurotrauma

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Cranial nerve palsies are relatively common after trauma, but trochlear nerve palsy is relatively uncommon. Although traumatic trochlear nerve palsy is easy to diagnose clinically because of extraocular movement disturbances, radiologic evaluations of this condition are difficult to perform because of the nerve's small size. Here, we report the case of a patient with delayed traumatic trochlear nerve palsy associated with a traumatic subarachnoid hemorrhage (SAH) and the related radiological findings, as obtained with high-resolution three-dimensional (3D) magnetic resonance imaging (MRI). A 63-year-old woman was brought to the emergency room after a minor head trauma. Neurologic examinations did not reveal any focal neurologic deficits. Brain computed tomography showed a traumatic SAH at the left ambient cistern. The patient complained of vertical diplopia at 3 days post-trauma. Ophthalmologic evaluations revealed trochlear nerve palsy on the left side. High-resolution 3D MRI, performed 20 days post-trauma, revealed continuity of the trochlear nerve and its abutted course by the posterior cerebral artery branch at the brain stem. Chemical irritation due to the SAH and the abutting nerve course were considered causative factors. The trochlear nerve palsy completely resolved during follow-up. This case shows the usefulness of high-resolution 3D MRI for evaluating trochlear nerve palsy.

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“…A diplopia está entre os principais achados, relacionada a hipofunção do OS com consequente hiperfunção relativa do músculo OI. Em casos de hipofunção desse músculo causada por trauma, como no quadro do paciente apresentado, a diplopia é um sintoma frequente 6 . Como tentativa de atenuar essa dupla visão, o paciente adota uma posição de inclinação da cabeça para o lado contrário do nervo lesado e o queixo para baixo 7,8 .…”

Section: Discussionunclassified

Paresia do IV nervo com sinal de Bielschowsky positivo: um relato de caso

Costa¹,

França

Gouvêa³

et al. 2021

HRJ

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O nervo troclear participa do movimento extrínseco dos olhos, através do músculo oblíquo superior. Seu acometimento não é frequente entre as lesões dos pares cranianos e é comumente congênito, relacionado a hipertensão ou ao trauma. A lesão causada por trauma cranioencefálico (TCE) geralmente ocorre em acidente automobilístico, com trauma orbitário direto ou frontal e tem maior incidência no gênero masculino. Os principais achados incluem hipertropia, diplopia vertical, limitação da depressão em adução e inclinação da cabeça para o lado oposto ao músculo oblíquo superior paralisado, manobra conhecida como sinal de Bielchowsky positivo. O objetivo deste estudo é relatar o caso de um paciente de 54 anos, do gênero masculino, que apresentou diplopia após um TCE causado por um acidente automobilístico, tendo como principal hipótese, no momento da consulta, a paresia do IV nervo craniano à esquerda. A paresia dos nervos responsáveis pelos movimentos oculares após TCE é uma entidade com possibilidades de tratamento conservador e cirúrgico, que devem ser minuciosamente observados para melhor prognóstico e estratégia terapêutica.

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Ocular Movement Nerve Palsy After Mild Head Trauma

Cited by 17 publications

References 26 publications

Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Delayed Trochlear Nerve Palsy Following Traumatic Subarachnoid Hemorrhage: Usefulness of High-Resolution Three Dimensional Magnetic Resonance Imaging and Unusual Course of the Nerve

Paresia do IV nervo com sinal de Bielschowsky positivo: um relato de caso

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