title: The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study.
abstract: The aim of this study is to investigate the mechanism of injury of abducens nerve at petroclival region in severe head trauma. Twenty specimens provided from 10 autopsied cases due to severe head trauma were investigated macroscopically and histopathogically. The slices of the abducens nerve taken consecutively along its course at petroclival region were stained with Hematoxylline-Eosin and evaluated under light microscope. In addition, coexisting cervical injuries in these cases were assessed macroscopically. Edema and perineural hemorrhagia of abducens nerve were identified in all cases. Nerve injury was found more exaggerated at the sites of dural entry point and petrous apex than any other parts of the abducens nerve. Furthermore, microscopically, also remarkable perineural hemorrhage of the abducens nerve was observed at the site of its anastomoses with the sympathetic plexus on the lateral wall of the internal carotid artery (ICA). Abducens nerve is injured at the sites of dural entry point, petrous apex and lateral wall of the ICA, directly proportional with the severity of the trauma. This finding is also significant in verification of the severe head trauma.
authors.affiliation: National Forensic Institute of Ministry of Justice, Cerrahpasa, Istanbul 34098, Turkey. bulentsam@yahoo.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Sam
authors.forename: Mehmet Faik
authors.initials: MF
authors.lastname: Ozveren
authors.forename: Ismail
authors.initials: I
authors.lastname: Akdemir
authors.forename: Cahide
authors.initials: C
authors.lastname: Topsakal
authors.forename: Bengu
authors.initials: B
authors.lastname: Cobanoglu
authors.forename: Cetin Lutfi
authors.initials: CL
authors.lastname: Baydar
authors.forename: Ozer
authors.initials: O
authors.lastname: Ulukan
mesh_terms: D020434:Abducens Nerve Diseases / Q000473:pathology; D020222:Abducens Nerve Injury / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001099:Arachnoid / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D006259:Craniocerebral Trauma / Q000473:pathology*; D004487:Edema / Q000473:pathology; D004912:Erythrocytes / Q000473:pathology; D005554:Forensic Medicine; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D008875:Middle Aged