Traumatic unilateral internuclear ophthalmoplegia.
A 23-year-old man was admitted for a closed head injury following a fall from a height of 5 meters from a ladder. Because of a C-7 burst fracture, a halo and halo vest were applied approximately 9 hours following the fall. Approximately 21 hours after the accident, the patient complained of diplopia. On neuro-ophthalmology evaluation, a unilateral internuclear ophthalmoplegia was noted. MRI of the brain, performed 3 days after application of the halo and vest, showed a small infarct at the posterior aspect of the inferior midbrain, slightly left of midline. At 9.5 weeks there was 90% improvement of the internuclear ophthalmoplegia noted. Of the reported cases in the medical literature of traumatic internuclear ophthalmoplegia, 30 (83.33%) cases were male and 6 (16.67%) were female. The mean age was 31.7. 54% of the cases were bilateral; 46% unilateral. Mechanisms include: motor vehicle accident: 28 (41.79%), fall: 7 (10.45%), blunt trauma: 11 (16.42%), penetrating trauma 1: (1.49%), bike accident 3: (4.48%), other: 1 (1.49%), Unknown: 16 (23.88%).
Doe
Joseph W
JW
Department of Ophthalmology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Jay
Walter M
WM
D000328:Adult; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011149:Pons / Q000503:physiopathology; D016896:Treatment Outcome