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Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2016; 35(04): 310-311
DOI: 10.1055/s-0036-1593853
Case Report | Relato de Caso
Thieme Publicações Ltda Rio de Janeiro, Brazil

Traumatic Oculomotor Nerve Avulsion after Mild Head Injury

Avulsão traumática do nervo oculomotor após traumatismo craniano leve
Leonardo Welling
1   Department of Neurosurgery, Universidade Estadual de Ponta Grossa, Ponta Grossa – PR, Brazil
,
Mariana Welling
2   Department of Neurology, Universidade Estadual de Ponta Grossa, Ponta Grossa – PR, Brazil
,
Eduardo Antunes
1   Department of Neurosurgery, Universidade Estadual de Ponta Grossa, Ponta Grossa – PR, Brazil
,
Ariana Jumes
1   Department of Neurosurgery, Universidade Estadual de Ponta Grossa, Ponta Grossa – PR, Brazil
,
Roberto Umeda
3   Clinica da Imagem, Ponta Grossa, Brazil
,
Eberval Gadelha Figueiredo
4   Department of Neurosurgery, Universidade de São Paulo (USP), São Paulo, Brazil
› Institutsangaben
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Publikationsverlauf

05. September 2016

04. Oktober 2016

Publikationsdatum:
16. November 2016 (online)

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Abstract

The authors describe a 37-year-old female who suffered a mild head injury after a car accident. She was found with an initial Glasgow coma scale score of 15. On further inspection, complete right ophthalmoplegia was observed. Initial computerized tomography (CT) scan of the head was normal, but magnetic resonance imaging showed right oculomotor nerve avulsion. The patient was discharged from the hospital without any improvement in complete ophthalmoplegia. To our knowledge, this is the first radiographically documented case of oculomotor nerve root avulsion with associated irreversible oculomotor nerve palsy after mild head injury. Considering the poor prognosis for recovery of the nerve function, an appropriate counseling should be provided to the patient and family. Neurosurgical techniques for attempting nerve reconstruction have yet to be investigated but could be a new area for clinical and surgical research.

Resumo

Os autores descrevem o caso de uma mulher de 37 anos, vítima de acidente automobilístico, com traumatismo craniano leve. No exame inicial, a pontuação da paciente estava em 15, segundo a escala de coma de Glasgow. Na inspeção adicional, observou-se oftalmoplegia completa à direita. A tomografia de crânio da admissão estava normal, porém a ressonância magnética de crânio evidenciou avulsão do nervo oculomotor direito. A paciente recebeu alta sem nenhuma melhora no quadro de oftalmoplegia. Até onde sabemos, esse é o primeiro caso documentado radiograficamente de avulsão da raiz do nervo oculomotor associada a paralisia irreversível do mesmo após traumatismo craniano leve. Considerando o prognóstico de recuperação ruim, aconselhamento apropriado deve ser feito a paciente e familiares. Técnicas para reconstrução desse nervo ainda não foram investigadas, mas podem vir a ser uma nova área de pesquisa clínica e cirúrgica.

Keywords

oculomotor nerve - head injury - avulsion

Palavras-chave

nervo oculomotor - traumatismo craniano - avulsão
 

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