title: Bilateral internuclear ophthalmoplegia and clivus fracture following head injury: case report.
abstract: Internuclear ophthalmoplegia is a remarkable finding, particularly in patients victims of head injury. The medial longitudinal fasciculus, which is believed to be lesioned in cases of internuclear ophthalmoplegia, has an unique brain stem position and the mechanism involved in brain stem contusions implies a maximal intensity of shearing forces on the skull base. We describe a very rare association of bilateral ophthalmoplegia and clivus fracture following head injury, without further neurological signs. The patient history, his physical examination and the image investigation provide additional evidence to some of the mechanisms of injury proposed to explain post-traumatic internuclear ophthalmoplegia.
authors.affiliation: Disciplina de Neurocirurgia, Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brasil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bonilha
authors.forename: Yvens Barbosa
authors.initials: YB
authors.lastname: Fernandes
authors.forename: João Paulo de Vasconcelos
authors.initials: JP
authors.lastname: Mattos
authors.forename: Wilson Adriano Abraão
authors.initials: WA
authors.lastname: Borges
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
mesh_terms: D000328:Adult; D003388:Cranial Fossa, Posterior / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000209:etiology*; D012887:Skull Fractures / Q000150:complications*