Isolated Oculomotor Nerve Palsy in a Patient with Mild Traumatic Brain Injury
Keywords:
mild head trauma, isolated oculomotor nerve palsy, nuclear magnetic resonance, intraneural hemorrhageAbstract
Introduction: Isolated common oculomotor nerve palsy is an unusual complication after mild cranial cerebral trauma, and it is generally associated with other neurological deficits. There are few reports of this association.
Objective: To describe the case of a patient with isolated oculomotor nerve paralysis in the context of mild cranial cerebral trauma.
Clinical case report: This is the case of a 20-year-old female patient with head trauma in the frontal region, with no loss of consciousness, she had subsequent isolated involvement of the extraocular movements of her right eye, eyelid ptosis and non-reactive mydriasis, besides normal findings in the simple skull tomography. Contrast-enhanced nuclear magnetic resonance imaging showed uptake at the apparent origin of the cranial nerve located in the midbrain, with no surgical indication. The evolution tended towards improvement after six months of treatment.
Conclusions: Isolated paralysis of the common oculomotor nerve is a rare complication after mild cranial cerebral trauma, but the pathophysiology of this event is not clear based on current scientific evidence, so clinical suspicion should guide the imaging protocol to determine focal nerve lesions. Steroids have been used as pharmacological method in these events and the functional prognosis is variable in the literature.
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