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Isolated unilateral oculomotor nerve neuropraxia following a trivial fall in a patient with calcified posterior petroclinoid ligament.

Patwardhan MA - Asian J Neurosurg (2015 Jan-Mar)

Bottom Line: We report a case of this condition.A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall.She did not show any clinical or radiological signs of head injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Jawaharlal Nehru Medical College, DMIMS, Wardha, Maharashtra, India.

ABSTRACT
Isolated traumatic oculomotor nerve palsy caused by a trivial fall is extremely rare. We report a case of this condition. A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall. She did not show any clinical or radiological signs of head injury. Computerized tomography revealed a calcified posterior petroclinoid ligament which has direct anatomical and pathological relation with the oculomotor nerve.

No MeSH data available.


Related in: MedlinePlus

(a and b) Eight months follow-up of the lady who sustained traumatic isolated oculomotor nerve injury on the left side showed complete recovery of ptosis with minor residual squint
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Figure 3: (a and b) Eight months follow-up of the lady who sustained traumatic isolated oculomotor nerve injury on the left side showed complete recovery of ptosis with minor residual squint

Mentions: A 49-year-old woman was brought to the accident and emergency department with history of a fall and ended up with right side of the face hitting the floor, while doing household work. She did not lose consciousness, neither had any episode of memory loss, nausea nor bleeding from nose, mouth and ear. On examination, she was oriented, and Glasgow coma Scale was 15/15. Her vital signs were normal. Left sided ptosis with dilated pupil was noted. There were abrasions and lacerated wounds over her right cheek and chin [Figure 1]. Her cardiovascular system, respiratory system and nervous system were clinically normal. Radiographs of the skull, cervical spine, and chest were normal. Computed tomography of the head and Magnetic resonance imaging of the brain ruled out head injury. The CT scan was again reviewed by a neuroradiologist who revealed calcified posterior PCLs on both the sides [Figure 2a and b]. Her urinary fluoride level was 4.5 mg/l; however, she did not show radiological signs of skeletal fluorosis. Patient was treated conservatively for her ophthalmic complaints and did not receive any surgical intervention for the same. At the end of 8 months follow-up, the ptosis recovered completely with occasional complaints of headache and her pupillary reflex also returned to normal [Figure 3a and b].


Isolated unilateral oculomotor nerve neuropraxia following a trivial fall in a patient with calcified posterior petroclinoid ligament.

Patwardhan MA - Asian J Neurosurg (2015 Jan-Mar)

(a and b) Eight months follow-up of the lady who sustained traumatic isolated oculomotor nerve injury on the left side showed complete recovery of ptosis with minor residual squint
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352643&req=5

Figure 3: (a and b) Eight months follow-up of the lady who sustained traumatic isolated oculomotor nerve injury on the left side showed complete recovery of ptosis with minor residual squint
Mentions: A 49-year-old woman was brought to the accident and emergency department with history of a fall and ended up with right side of the face hitting the floor, while doing household work. She did not lose consciousness, neither had any episode of memory loss, nausea nor bleeding from nose, mouth and ear. On examination, she was oriented, and Glasgow coma Scale was 15/15. Her vital signs were normal. Left sided ptosis with dilated pupil was noted. There were abrasions and lacerated wounds over her right cheek and chin [Figure 1]. Her cardiovascular system, respiratory system and nervous system were clinically normal. Radiographs of the skull, cervical spine, and chest were normal. Computed tomography of the head and Magnetic resonance imaging of the brain ruled out head injury. The CT scan was again reviewed by a neuroradiologist who revealed calcified posterior PCLs on both the sides [Figure 2a and b]. Her urinary fluoride level was 4.5 mg/l; however, she did not show radiological signs of skeletal fluorosis. Patient was treated conservatively for her ophthalmic complaints and did not receive any surgical intervention for the same. At the end of 8 months follow-up, the ptosis recovered completely with occasional complaints of headache and her pupillary reflex also returned to normal [Figure 3a and b].

Bottom Line: We report a case of this condition.A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall.She did not show any clinical or radiological signs of head injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Jawaharlal Nehru Medical College, DMIMS, Wardha, Maharashtra, India.

ABSTRACT
Isolated traumatic oculomotor nerve palsy caused by a trivial fall is extremely rare. We report a case of this condition. A 49-year-old woman had distal radius fracture and ptosis on the same side after having a trivial domestic fall. She did not show any clinical or radiological signs of head injury. Computerized tomography revealed a calcified posterior petroclinoid ligament which has direct anatomical and pathological relation with the oculomotor nerve.

No MeSH data available.


Related in: MedlinePlus