Traumatic lesions of the optic, oculomotor, trochlear, and abducens nerves--computer tomographic findings

Traumatic lesions of the oculomotor and optic nerves are usually associated with multiple injuries which pose difficulties for radiological examination. In 54 patients with functional disturbances of the optic, oculomotor, trochlear, or abducens nerve following severe multiple injuries, the initial computer tomographic examination was unable to document conclusively direct nerve damage. Indirect signs of nerve damage in the form of orbital and midface fractures were often found in the presence of optic and oculomotor nerve impairments, but seldom in the case of abducens nerve deficits. The causes of trochlear pareses could not be established. Thus, CT can only provide indirect evidence of injuries to the optic and oculomotor nerves. The nerve damage itself can only be demonstrated in a target examination made after the patient's condition has stabilized.