Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Isolated Oculomotor Nerve Palsy Following Minor Head Trauma : Case Illustration and Literature Review

  • Kim, Ealmaan (Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Chang, Hyukwon (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine)
  • Received : 2013.05.17
  • Accepted : 2013.11.14
  • Published : 2013.11.28
Download PDF
⟨ Previous Next ⟩

Abstract

Isolated oculomotor nerve palsy (ONP) attributable to mild closed head trauma is a distinct rarity. Its diagnosis places high demands on the radiologist and the clinician. The authors describe this condition in a 36-year-old woman who slipped while walking and struck her face. Initial computed tomography did not reveal any causative cerebral and vascular lesions or orbital and cranial fractures. Enhancement and swelling of the cisternal segment of the oculomotor nerve was seen during the subacute phase on thin-sectioned contrast-enhanced magnetic resonance images. The current case received corticosteroid therapy, and then recovered fully in 13 months after injury. Possible mechanism of ONP from minor head injury is proposed and previous reports in the literature are reviewed.

Keywords

References

  1. Bruce BB, Biousse V, Newman NJ : Third nerve palsies. Semin Neurol 27 : 257-268, 2007 https://doi.org/10.1055/s-2007-979681
  2. Chen CC, Pai YM, Wang RF, Wang TL, Chong CF : Isolated oculomotor nerve palsy from minor head trauma. Br J Sports Med 39 : e34, 2005 https://doi.org/10.1136/bjsm.2004.016311
  3. Dhaliwal A, West AL, Trobe JD, Musch DC : Third, fourth, and sixth cranial nerve palsies following closed head injury. J Neuroophthalmol 26 : 4-10, 2006 https://doi.org/10.1097/01.wno.0000204661.48806.1d
  4. Elston JS : Traumatic third nerve palsy. Br J Ophthalmol 68 : 538-543, 1984 https://doi.org/10.1136/bjo.68.8.538
  5. Eyster EF, Hoyt WF, Wilson CB : Oculomotor palsy from minor head trauma. An initial sign of basal intracranial tumor. JAMA 220 : 1083-1086, 1972 https://doi.org/10.1001/jama.1972.03200080027006
  6. Hosoya T, Adachi M, Yamaguchi K, Yamaguchi K, Kato T, Sugai Y : Abducens nerve enhancement demonstrated by multiplanar reconstruction of contrast-enhanced three-dimensional MRI. Neuroradiology 43 : 295-301, 2001 https://doi.org/10.1007/s002340000338
  7. Janssen K, Wojciechowski M, Poot S, De Keyser K, Ceulemans B : Isolated abducens nerve palsy after closed head trauma : a pediatric case report. Pediatr Emerg Care 24 : 621-623, 2008 https://doi.org/10.1097/PEC.0b013e3181850c5c
  8. Kaido T, Tanaka Y, Kanemoto Y, Katsuragi Y, Okura H : Traumatic oculomotor nerve palsy. J Clin Neurosci 13 : 852-855, 2006 https://doi.org/10.1016/j.jocn.2005.08.020
  9. Kruger M, Noel P, Ectors P : Bilateral primary traumatic oculomotor nerve palsy. J Trauma 26 : 1151-1153, 1986 https://doi.org/10.1097/00005373-198612000-00021
  10. Kuo LT, Huang AP, Yang CC, Tsai SY, Tu YK, Huang SJ : Clinical outcome of mild head injury with isolated oculomotor nerve palsy. J Neurotrauma 27 : 1959-1964, 2010 https://doi.org/10.1089/neu.2010.1407
  11. Levy RL, Geist CE, Miller NR : Isolated oculomotor palsy following minor head trauma. Neurology 65 : 169, 2005 https://doi.org/10.1212/01.wnl.0000167288.10702.03
  12. Liu YT, Lee YC, Liu HC : Isolated oculomotor nerve palsy due to head injury. J Chin Med Assoc 67 : 149-151, 2004
  13. Mark AS, Casselman J, Brown D, Sanchez J, Kolsky M, Larsen TC 3rd, et al. : Ophthalmoplegic migraine : reversible enhancement and thickening of the cisternal segment of the oculomotor nerve on contrast-enhanced MR images. AJNR Am J Neuroradiol 19 : 1887-1891, 1998
  14. Memon MY, Paine KW : Direct injury of the oculomotor nerve in craniocerebral trauma. J Neurosurg 35 : 461-464, 1971 https://doi.org/10.3171/jns.1971.35.4.0461
  15. Muthu P, Pritty P : Mild head injury with isolated third nerve palsy. Emerg Med J 18 : 310-311, 2001 https://doi.org/10.1136/emj.18.4.310
  16. Nagaseki Y, Shimizu T, Kakizawa T, Fukamachi A, Nukui H : Primary internal ophthalmoplegia due to head injury. Acta Neurochir (Wien) 97 : 117-122, 1989 https://doi.org/10.1007/BF01772821
  17. Quisling SV, Shah VA, Lee HK, Policeni B, Smoker WR, Martin C, et al. : Magnetic resonance imaging of third cranial nerve palsy and trigeminal sensory loss caused by herpes zoster. J Neuroophthalmol 26 : 47-48, 2006 https://doi.org/10.1097/01.wno.0000204660.41183.1b
  18. Walter KA, Newman NJ, Lessell S : Oculomotor palsy from minor head trauma : initial sign of intracranial aneurysm. Neurology 44 : 148-150, 1994 https://doi.org/10.1212/WNL.44.1.148

Cited by

  1. Isolated unilateral oculomotor nerve palsy due to head trauma vol.10, pp.3, 2013, https://doi.org/10.4103/1793-5482.161169
  2. Trauma of the midface vol.14, pp.None, 2013, https://doi.org/10.3205/cto000121
  3. Electrical stimulation promotes regeneration of injured oculomotor nerves in dogs vol.11, pp.10, 2013, https://doi.org/10.4103/1673-5374.193248
  4. Intraneural hemorrhage in traumatic oculomotor nerve palsy vol.12, pp.1, 2017, https://doi.org/10.1016/j.radcr.2016.11.025
  5. Bilateral Oculomotor Nerve Palsy after Head Trauma: A Case Report vol.30, pp.2, 2013, https://doi.org/10.20408/jti.2017.30.2.66
  6. Clinical Significance of Isolated Third Cranial Nerve Palsy in Traumatic Brain Injury: A Detailed Description of Four Different Mechanisms of Injury through the Analysis of Our Case Series and Review vol.2021, pp.None, 2021, https://doi.org/10.1155/2021/5550371