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Delayed bilateral abducens nerve palsy after head trauma.
Min-Su Kim1, Min-Soo Cho, Seong-Ho Kim
1Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea.
Journal of Korean Neurosurgical Society
|January 13, 2009
Summary
Bilateral abducens nerve palsy and hypoglossal nerve palsy are rare complications of head trauma. This case report details a patient experiencing these palsies after head injury, with CT scans revealing epidural hematoma and subarachnoid hemorrhage.
Area of Science:
- Neuroscience
- Trauma Surgery
- Ophthalmology
Background:
- Unilateral abducens nerve palsy is a known complication of head trauma.
- Bilateral abducens nerve palsy following trauma is exceptionally rare, with limited documented cases.
Observation:
- A patient presented with bilateral abducens nerve palsy and hypoglossal nerve palsy three days post-head trauma.
- The patient maintained a Glasgow Coma Score of 15, indicating no initial severe neurological impairment.
- Computed tomography (CT) revealed clivus epidural hematoma and subarachnoid hemorrhage at the basal cistern.
Findings:
- The presence of clivus epidural hematoma and basal subarachnoid hemorrhage correlated with the development of bilateral cranial nerve palsies.
- This suggests a potential mechanism involving direct compression or ischemic injury to the abducens and hypoglossal nerves.
Implications:
- Highlights the importance of considering rare neurological deficits after head trauma.
- Informs diagnostic workup and management strategies for traumatic cranial nerve palsies.
- Contributes to understanding the pathophysiology of nerve injury secondary to intracranial hematomas.
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