Ocular Movement Nerve Palsy After Mild Head Trauma

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• 作者：Guichen Li¹ ; Xiaobo Zhu² ; Xiuhong Gu³ ; Yang Sun² ; Xianfeng Gao² ; Yang Zhang² ; ^{zhangyang_930@126.com" class="auth_mail" title="E-mail the corresponding author} ; Kun Hou² ; ^{hkyyayz@yeah.net" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Abducens nerve ; Cranial nerve palsy ; Mild head trauma ; Ocular movement nerve ; Oculomotor nerve ; Trochlear nerve
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：94
• 期：Complete
• 页码：296-302
• 全文大小：4340 K

文摘

Ocular movement nerve (cranial nerve III, IV and VI) palsy (OMNP) is rarely encountered after mild head trauma. As a result of the inconsistent definition of this specific entity in published studies, it is difficult to offer an accurate management strategy and prognosis assessment to affected patients.

Methods

A retrospective review of the medical records of the patients at the First Hospital of Jilin University combined with a systematic review of published studies was conducted.

Results

Thirty-one patients (17 females, 55%), including 6 cases in our institution, were identified in this systematic review. Cranial nerves III, IV, and VI were involved in 54.8%, 3.2%, and 45.2% of the patients, respectively. Although all the patients in our case series experienced complete resolution, only 54.6% experienced complete resolution in a time course of 10 days to 13 months. Additional intracranial findings other than traumatic brain injury on imaging modalities that might predispose to OMNP after mild head trauma were identified in 25.8% of the patients.

Conclusions

OMNP after mild head trauma is a rare entity in neurosurgical practice. In patients with no positive intracranial finding, observation and follow-up are the mainstay of management. If any underlying intracranial lesions are identified, the management should be focused on the underlying lesions. From the data available, mild trauma does not mean mild injury or favorable recovery in OMNP after mild head trauma.