Limits...
Isolated unilateral oculomotor nerve palsy due to head trauma.

Erenler AK, Yalçın A, Baydin A - Asian J Neurosurg (2015 Jul-Sep)

Bottom Line: Patient was consulted with an ophthalmologist and any sign of direct trauma to the eye was not determined.Then, the patient was consulted with a neurosurgeon and hospitalized.Neurosurgeons and ED physicians must be careful about this rare condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey.

ABSTRACT
Unilateral oculomotor nerve palsy is a rare and challenging condition for both emergency department (ED) physicians and neurosurgeons. In this report, we present you a case of head trauma with oculomotor nerve palsy whose initial neuroimaging findings were normal. A 50-year-old female presented to our ED due to head trauma secondary to fall from height. On her physical examination, ptosis, minimal lateral deviation, and dilated pupilla unresponsive to the light were determined in the left eye. A computed tomography and magnetic resonance imaging were performed and both were found to be normal. Patient was consulted with an ophthalmologist and any sign of direct trauma to the eye was not determined. Then, the patient was consulted with a neurosurgeon and hospitalized. In some rare instances, minor traumas to the head may result in isolated oculomotor nerve palsy without accompanying findings. Neurosurgeons and ED physicians must be careful about this rare condition.

No MeSH data available.


Related in: MedlinePlus

Computed tomography of the patient was reported to be normal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553751&req=5

Figure 2: Computed tomography of the patient was reported to be normal

Mentions: A 50-year-old female patient with no past medical history was admitted to our emergency department (ED) due to fall from height in the house. The patient suffered a dropped left upper eyelid and double vision immediately after falling. On admission, vital signs of the patient were normal. On physical examination, ecchymotic lesions on left temporal region of the head and left orbital were observed. On neurological examination, the patient was oriented and cooperated. Abnormal findings were ptosis of the left eye, minimal deviation of the eye ball laterally, and dilated nonreactive pupil at the same side [Figure 1]. Examination of the right eye was normal with normal range of movements with normal size and reactivity of the pupil. Other system examinations were normal. Trauma X-rays were performed and found to be normal. Furthermore, a computed tomography (CT) scan of the brain was performed in order to exclude a possible bleeding or fracture and reported to be normal [Figure 2]. Furthermore, a magnetic resonance imaging (MRI) was performed and reported by the radiologists as normal [Figure 3]. Blood samples of the patient were obtained and laboratory results were normal. Because the left orbital was ecchymotic, a consultation with an ophthalmologist was performed and a possible direct injury to the eye was excluded. Patient was then consulted with a neurosurgeon and hospitalized with a diagnosis of isolated third nerve palsy.


Isolated unilateral oculomotor nerve palsy due to head trauma.

Erenler AK, Yalçın A, Baydin A - Asian J Neurosurg (2015 Jul-Sep)

Computed tomography of the patient was reported to be normal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553751&req=5

Figure 2: Computed tomography of the patient was reported to be normal
Mentions: A 50-year-old female patient with no past medical history was admitted to our emergency department (ED) due to fall from height in the house. The patient suffered a dropped left upper eyelid and double vision immediately after falling. On admission, vital signs of the patient were normal. On physical examination, ecchymotic lesions on left temporal region of the head and left orbital were observed. On neurological examination, the patient was oriented and cooperated. Abnormal findings were ptosis of the left eye, minimal deviation of the eye ball laterally, and dilated nonreactive pupil at the same side [Figure 1]. Examination of the right eye was normal with normal range of movements with normal size and reactivity of the pupil. Other system examinations were normal. Trauma X-rays were performed and found to be normal. Furthermore, a computed tomography (CT) scan of the brain was performed in order to exclude a possible bleeding or fracture and reported to be normal [Figure 2]. Furthermore, a magnetic resonance imaging (MRI) was performed and reported by the radiologists as normal [Figure 3]. Blood samples of the patient were obtained and laboratory results were normal. Because the left orbital was ecchymotic, a consultation with an ophthalmologist was performed and a possible direct injury to the eye was excluded. Patient was then consulted with a neurosurgeon and hospitalized with a diagnosis of isolated third nerve palsy.

Bottom Line: Patient was consulted with an ophthalmologist and any sign of direct trauma to the eye was not determined.Then, the patient was consulted with a neurosurgeon and hospitalized.Neurosurgeons and ED physicians must be careful about this rare condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Çorum Education and Research Hospital, Hitit University, Çorum, Turkey.

ABSTRACT
Unilateral oculomotor nerve palsy is a rare and challenging condition for both emergency department (ED) physicians and neurosurgeons. In this report, we present you a case of head trauma with oculomotor nerve palsy whose initial neuroimaging findings were normal. A 50-year-old female presented to our ED due to head trauma secondary to fall from height. On her physical examination, ptosis, minimal lateral deviation, and dilated pupilla unresponsive to the light were determined in the left eye. A computed tomography and magnetic resonance imaging were performed and both were found to be normal. Patient was consulted with an ophthalmologist and any sign of direct trauma to the eye was not determined. Then, the patient was consulted with a neurosurgeon and hospitalized. In some rare instances, minor traumas to the head may result in isolated oculomotor nerve palsy without accompanying findings. Neurosurgeons and ED physicians must be careful about this rare condition.

No MeSH data available.


Related in: MedlinePlus