The mechanism of injury of the abducens nerve in severe head trauma: a postmortem study.
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.
Sam
Bulent
B
National Forensic Institute of Ministry of Justice, Cerrahpasa, Istanbul 34098, Turkey. bulentsam@yahoo.com
Ozveren
Mehmet Faik
MF
Akdemir
Ismail
I
Topsakal
Cahide
C
Cobanoglu
Bengu
B
Baydar
Cetin Lutfi
CL
Ulukan
Ozer
O
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