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[Traumatic bilateral oculomotor nerve palsy: a case report].
S Nakashima1, M Abe, K Tabuchi
1Department of Neurosurgery, Saga Medical School, Japan.
No Shinkei Geka. Neurological Surgery
|April 1, 1992
Summary
This case study details a rare instance of bilateral traumatic oculomotor palsy following a motor vehicle accident. The patient experienced significant neurological deficits, including fixed dilated pupils and ptosis, which gradually improved with conservative treatment.
Area of Science:
- Neuroscience
- Trauma Surgery
- Ophthalmology
Background:
- Motor vehicle accidents can cause severe head trauma.
- Oculomotor nerve palsy is a potential complication of head injuries.
- Bilateral traumatic oculomotor palsy is exceptionally rare.
Observation:
- A 28-year-old female sustained head trauma in a motor vehicle accident.
- Initial presentation included semicomatose state, bilaterally fixed dilated pupils (6mm), ptosis, and bilateral eye abduction.
- Imaging revealed subdural hematomas, contusional lesions in the medial temporal lobes, and a pelvic fracture.
Findings:
- The patient exhibited bilateral traumatic oculomotor palsy with initial fixed 6mm pupils.
- Conservative management with diuretics and steroids led to gradual neurological improvement.
- Ocular deficits, including ptosis and pupil abnormalities, showed partial recovery over 6 months.
Implications:
- This case highlights the potential for severe ocular motor nerve dysfunction after significant head trauma.
- The exact mechanism of bilateral traumatic oculomotor palsy remains unclear, suggesting complex injury pathways.
- Understanding these mechanisms is crucial for diagnosing and managing similar rare traumatic brain injuries.