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Minimally Invasive Surgical Decompression of Occipital Nerves
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Isolated third nerve palsy from mild closed head trauma.

Mohammad Reza Najafi1, Noushin Mehrbod

  • 1Neurology Department, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. najafi@med.mui.ac.ir

Archives of Iranian Medicine
|August 29, 2012
PubMed
Summary

Minor head trauma can cause oculomotor nerve palsy, affecting eye movement and pupil response. This case highlights a rare isolated injury following mild head trauma (GCS 14-15).

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Trauma Surgery

Background:

  • Head injuries are frequent in motor vehicle accidents, often leading to cranial nerve damage.
  • Existing research on cranial nerve injuries from mild head trauma (Glasgow Coma Scale 14-15) is limited.
  • The oculomotor nerve (cranial nerve III) controls key eye functions, including eyelid elevation, pupil constriction, and most eye movements.

Observation:

  • This report details a rare case of a completely isolated oculomotor nerve palsy.
  • The palsy was directly associated with a minor head injury, not other causative lesions.
  • Clinical signs included ptosis, a non-reactive pupil, and impaired eye movement.

Findings:

  • Mild head trauma can result in isolated oculomotor nerve palsy.

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  • Complete oculomotor nerve injury presents with characteristic symptoms: ptosis, pupillary abnormalities, and ophthalmoplegia.
  • The case underscores the potential for significant neurological deficits from seemingly minor head trauma.

    • Implications:

    • Clinicians should consider oculomotor nerve palsy in patients presenting with symptoms after mild head injuries.
    • Further research is warranted to understand the mechanisms and prevalence of cranial nerve palsies following mild head trauma.
    • Prompt diagnosis and management are crucial for patients with oculomotor nerve palsy to prevent long-term visual impairment and address underlying causes.