Bilateral internuclear ophthalmoplegia and clivus fracture following head injury: case report.
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.
Bonilha
Leonardo
L
Disciplina de Neurocirurgia, Departamento de Neurologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Brasil.
Fernandes
Yvens Barbosa
YB
Mattos
João Paulo de Vasconcelos
JP
Borges
Wilson Adriano Abraão
WA
Borges
Guilherme
G
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*