[Injuries of cranial nerves II-VII from mortal closed head injuries]

Brain autopsy was carried out in 12 patients who died within 3 days of closed head injury. A segment of the brain stem with the entire intracranial portions of nerves II-VII was dissected in each case, fixed in formaline and inspected thoroughly under magnification. Injuries to the examined nerves were seen in 9 subjects. The oculomotor nerve was torn out of the midbrain unilaterally in 3 and bilaterally in 2 cases. In one patient only a portion of the superficial fibres on the medial aspect of the nerve was ripped out from the brainstem. In two patients the IV nerve was ruptured. The root of nerve V was contused in one case. Bilateral avulsion of the root of the VIth nerve from the brainstem was found in two cases. The initial segment of the facial nerve was crushed in two subjects. No visible injury to the ophthalmic nerves was found in any of the cases examined. The results suggest that cranial nerves related to the visual system are subject to serious injury in most cases of severe closed head trauma.