Localization of traumatic oculomotor nerve palsy to the midbrain exit site by magnetic resonance imaging.
OBJECTIVE
To present the magnetic resonance imaging findings for a patient with traumatic oculomotor nerve injury.


METHODS
We examined a patient with a right pupil-involving oculomotor nerve palsy after severe closed head trauma.


RESULTS
Magnetic resonance imaging of the brain demonstrated marked signal hypointensity on gradient-echo T2*-weighted images consistent with hemorrhage at the midbrain exit site of the right oculomotor nerve.


CONCLUSIONS
Distal fascicular damage or partial rootlet avulsion is a mechanism of injury in some traumatic oculomotor nerve palsies. Gradient-echo T2*-weighted magnetic resonance imaging is the most sensitive method to detect hemorrhagic changes associated with shearing injury.
Balcer
L J
LJ
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA.
Galetta
S L
SL
Bagley
L J
LJ
Pakola
S J
SJ
D000063:Accidents, Traffic; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000175:diagnosis; D005131:Eye Injuries / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008636:Mesencephalon / Q000293:injuries* / Q000473:pathology; D009802:Oculomotor Nerve / Q000473:pathology; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis*; D061220:Oculomotor Nerve Injuries; D011681:Pupil Disorders / Q000175:diagnosis; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*