Traumatic Oculomotor Nerve Avulsion after Mild Head Injury

• Main Authors: Leonardo Welling, Mariana Welling, Eduardo Antunes, Ariana Jumes, Roberto Umeda, Eberval Gadelha Figueiredo
• Format: Article
• Language: English
• Published: Thieme Revinter Publicações Ltda. 2016-11-01
• Series: Brazilian Neurosurgery
• Subjects: oculomotor nerve; head injury; avulsion
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1593853

The authors describe a 37-year-old female who suffered a mild head injury after a car accident. She was found with an initial Glasgow coma scale score of 15. On further inspection, complete right ophthalmoplegia was observed. Initial computerized tomography (CT) scan of the head was normal, but magnetic resonance imaging showed right oculomotor nerve avulsion. The patient was discharged from the hospital without any improvement in complete ophthalmoplegia. To our knowledge, this is the first radiographically documented case of oculomotor nerve root avulsion with associated irreversible oculomotor nerve palsy after mild head injury. Considering the poor prognosis for recovery of the nerve function, an appropriate counseling should be provided to the patient and family. Neurosurgical techniques for attempting nerve reconstruction have yet to be investigated but could be a new area for clinical and surgical research.