[Bilateral direct injury of oculomotor nerves in craniocerebral trauma-report of a case (author's transl)].
A 46-year-old housewife was admitted to the Kawasaki Hospital soon after traffic accident. She was struck in the right forehead. She was very slightly drowsy but well oriented. Both eyeballs were extremely abducted without any motility. The pupils were bilaterally dilated and equal in size with no response to light. There was a pronounced blephaloptosis on both sides. Another neurological abnormality was a slight right facial weakness. On skull films, a linear fracture in the right temporobasal region was noted but the views of the orbits were normal. A lumbal tap showed a mild subarachnoidal hemorrhage. Three weeks after the trauma, pneumoencephalography showed no abnormal finding. Throughout convalescence, no special treatment was given beyond medication. She improved steadily. Three years after injury, re-examination disclosed that lateral gaze was almost full to either side but upward and downward movements of both eyeballs were limited. In our opinion, the most likely cause of the disability in this case was bilateral direct damage of the oculomotor nerves near the petroclinoid ligament (Grüber).
D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000209:etiology*