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Posttraumatic pneumocephalus-induced bilateral oculomotor nerve palsy
Dursun Aygun1, Zahide Doganay, Ahmet Baydin
1Department of Emergency Medicine, Medical School, Ondukuz Mayis University, Samsun, Turkey. daygun@omu.edu.tr
Clinical Neurology and Neurosurgery
|November 29, 2005
Summary
This study reports a rare case of bilateral third nerve palsy following head trauma. Posttraumatic pneumocephalus may cause oculomotor nerve nuclear involvement.
Area of Science:
- Neuroscience
- Ophthalmology
- Trauma Surgery
Background:
- Bilateral third nerve palsy typically indicates nuclear involvement.
- Posttraumatic nuclear involvement causing third nerve palsy is exceptionally rare.
Observation:
- A 23-year-old male with a depressed skull fracture and severe head trauma (Glasgow Coma Scale Score of 9) presented with bilateral ptosis and unreactive pupils.
- Pupil diameters were 6.5 mm and 7.5 mm.
- Computed tomography revealed bilateral perimesensephalic pneumocephalus.
Findings:
- The patient exhibited bilateral oculomotor nerve paresis.
- This paresis was hypothesized to be associated with posttraumatic bilateral perimesensephalic pneumocephalus.
- The pneumocephalus likely affected the nucleus of the third cranial nerve.
Implications:
- This case highlights a potential, albeit rare, mechanism for third nerve palsy after head injury.
- It suggests that pneumocephalus can impact cranial nerve nuclei.
- Understanding this association is crucial for diagnosing and managing complex head trauma cases.
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