Cases reported "Abducens Nerve Injury"

Filter by keywords:



Filtering documents. Please wait...

1/14. Pseudo-entrapment of extraocular muscles in patients with orbital fractures.

    diplopia is a prominent finding in patients who have suffered orbital fractures. If the patient's double vision or ocular motility restriction was caused by soft tissue entrapment into the fracture site, surgery is frequently performed in order to release this entrapment and restore normal eye movement. However, the presence of diplopia should not necessarily be an indication for surgery. Brief case reports are hereby presented to illustrate that the symptoms of diplopia and motility restriction are not always attributable to the presence of orbital fractures that require surgical repair. The purpose of this article is to describe other causes of abnormal ocular motility that are associated with orbital trauma but which are not caused by soft tissue entrapment.
- - - - - - - - - -
ranking = 1
keywords = fracture
(Clic here for more details about this article)

2/14. Bilateral sixth nerve palsy after head trauma.

    Gaze deficits are not uncommon after head trauma and might be caused by injury to the central nervous system, the peripheral nerve, or the motor unit. Traumatic bilateral sixth cranial nerve palsies are a rare condition and are typically associated with additional intracranial, skull, and cervical spine injuries. We describe a case of a complete bilateral sixth nerve palsy in a 44-year-old male patient with trauma with no intracranial lesion, no associated skull or cervical spine fracture, and no altered level of consciousness. The emergency physician should be aware of the differential diagnosis, initial workup, and injuries associated with a traumatic gaze deficit.
- - - - - - - - - -
ranking = 0.19052342222348
keywords = fracture, skull
(Clic here for more details about this article)

3/14. Ocular palsy following Le Fort 1 osteotomy: a case report.

    A 33-year-old female patient developed an ipsilateral sixth nerve palsy and partial third nerve palsy following a Le Fort 1 osteotomy. Complete resolution occurred at 10 weeks.The likely mechanism of injury secondary to pterygo-maxillary dysjunction is highlighted, with description of the relevant anatomy.Previous cases of ocular motility complications following Le Fort 1 osteotomy are discussed.We recommend that significant care be taken in osteotome placement in the pterygo-maxillary fissure, particularly in those prone to unpredicted fractures such as older patients, or where the anatomy is congenitally abnormal or altered by previous surgery.
- - - - - - - - - -
ranking = 0.14285714285714
keywords = fracture
(Clic here for more details about this article)

4/14. Bitemporal head crush injuries: clinical and radiological features of a distinctive type of head injury.

    OBJECT: Most craniocerebral injuries are caused by mechanisms of acceleration and/or deceleration. Traumatic injuries following progressive compression to the head are certainly unusual. The authors reviewed clinical and radiological features in a series of patients who had sustained a special type of cranial crush injury produced by the bilateral application of rather static forces to the temporal region. Their aim was to define the characteristic clinical features in this group of patients and to assess the mechanisms involved in the production of the cranial injuries and those of the associated cerebral and endocrine lesions found in this peculiar type of head injury. methods: Clinical records of 11 patients were analyzed with regard to the state of consciousness, cranial nerve involvement, findings on neuroimaging studies, endocrine symptoms, and outcome. Furthermore, an experimental model of bitemporal crush injury was developed by compressing a dried skull with a carpenter's vice. Seven of the 11 patients were 16 years old or younger. All patients presented with a characteristic clinical picture consisting of no loss of consciousness (six patients), epistaxis (nine patients), otorrhagia (11 patients), peripheral paralysis of the sixth and/or seventh cranial nerves (10 patients), hearing loss (five patients), skull base fractures (11 patients), pneumocephalus (11 patients), and diabetes insipidus (seven patients). Ten patients survived the injury and most recovered neurological function. CONCLUSIONS: Static forces applied to the head in a transverse axis produce fractures in the skull base that cross the midline structures without producing significant cerebral damage. Stretching of cranial nerves at the skull base explains the nearly universal finding of paralysis of these structures, whereas an increase in the vertical diameter of the skull accounts for the occurrence of diabetes insipidus in the presence of an intact function of the anterior pituitary lobe. The association of clinical, endocrine, and neuroimaging findings encountered in this peculiar type of head injury supports the idea that this subset of injured patients has a distinctive clinical condition, namely the syndrome of bitemporal crush injury to the head.
- - - - - - - - - -
ranking = 0.40487998413013
keywords = fracture, skull
(Clic here for more details about this article)

5/14. Bilateral traumatic facial paralysis associated with unilateral abducens palsy: a case report.

    Bilateral traumatic facial paralysis is a very rare clinical condition. Abducens palsy, associated with bilateral traumatic paralysis, is even rarer and has not been well described in the literature. In this report, a 24-year-old male, who developed immediate bilateral facial and right abducens paralyses following a motor vehicle accident, is presented. The patient was referred for neurotologic evaluation 22 days after the injury. Electroneurography (ENoG) demonstrated 100 per cent degeneration at the first examination and, correspondingly, electromyography showed no regeneration potentials. Using high-resolution computed tomography (HRCT), a longitudinal fracture on the right and a mixed-type fracture on the left were identified. The patient had good cochlear reserve on both sides. The decision for surgery was based not on ENoG, because of the delayed referral of the patient, but on the HRCT, which showed clear fracture lines on both sides. The middle cranial fossa approach for decompression of the right facial nerve was performed on the 55th day following the trauma, and a combined procedure using the middle cranial fossa and transmastoid approaches was applied for decompression of the left facial nerve on the 75th day following the trauma. On the right, there was dense fibrosis surrounding the geniculate ganglion and the proximal tympanic segment whereas, on the left, bone fragments impinging on the geniculate ganglion, dense fibrosis surrounding the geniculate ganglion, and a less extensive fibrotic tissue surrounding the pyramidal segment were encountered. There were no complications or hearing deterioration. At the one-year follow up, the patient had House-Brackmann (HB) grade 1 recovery on the right, and HB grade 2 recovery on the left side, and the abducens palsy regressed spontaneously. The middle cranial fossa approach and its combinations can be performed safely in bilateral temporal bone fractures as labyrinthine sparing procedures if done on separate occasions.
- - - - - - - - - -
ranking = 0.57142857142857
keywords = fracture
(Clic here for more details about this article)

6/14. Carotid cavernous fistula after minimal facial trauma. Report of a case.

    The carotid cavernous fistula has historically been associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of a fracture through the base of the skull, which produces a force causing laceration of the internal carotid artery in the region where it approximates the cavernous sinus. We report a case in which apparently minimal head trauma resulted in the development of a carotid cavernous fistula. The rather innocuous presentation of this complication requires particular attention by the caregiver in assessing the patient sustaining maxillofacial trauma.
- - - - - - - - - -
ranking = 0.16669028254031
keywords = fracture, skull
(Clic here for more details about this article)

7/14. Traumatic bilateral abducent nerve palsies.

    A patient sustained a severe cranio-facial injury which included a transverse fracture of the middle cranial fossa through the sella turcica producing otorrhoea, rhinorrhoea, a bilateral abducents palsy and a large aero-coele. All gradually remitted spontaneously. The management of this patient and the patterns of cranial base fractures and their associated clinical features, particularly of the middle cranial fossa, are discussed.
- - - - - - - - - -
ranking = 0.28571428571429
keywords = fracture
(Clic here for more details about this article)

8/14. Transient abducens nerve palsy following a Le Fort I maxillary osteotomy: report of a case.

    A case of transient abducens nerve palsy following Le Fort I maxillary osteotomy is reported. The results of the CT scan strongly suggest the cause was a fracture of the body of the sphenoid bone but the cause of the fracture is unclear. The palsy occurred on the first postoperative day and recovery took approximately 5 months. The most likely explanation for the complication is a transmittal of force from the osteotome used to fracture through the pterygoid plates extending superiorly through the medial surface of the cavernous sinus. This case clearly demonstrates the importance of care in positioning of the pterygomaxillary osteotome.
- - - - - - - - - -
ranking = 0.42857142857143
keywords = fracture
(Clic here for more details about this article)

9/14. Unusual complications of temporal bone fractures.

    Eighty-two temporal bone fractures were diagnosed in 75 patients with high-resolution computed tomographic scanning. Excluding six gunshot injuries, 55 (72%) of the fractures were oblique, 11 (15%) were longitudinal, and ten (13%) were transverse. Facial paresis or paralysis occurred in 45 patients (60%), hemotympanum occurred in 67 (89%), and cerebrospinal fluid otorrhea occurred in 19 (25%). Among 66 patients in whom audiometry was performed, 20 (30%) had conductive hearing loss, nine (14%) had sensorineural loss, and 36 (55%) had mixed hearing loss. Vestibular symptoms were present in 23 patients (30%). Other unusual complications of temporal bone fractures were observed: bilateral abducens paralysis, three patients (4%); unilateral abducens paralysis, two (2.67%); trigeminal paralysis, one (1.33%); and aseptic sigmoid sinus thrombosis, one (1.33%).
- - - - - - - - - -
ranking = 1
keywords = fracture
(Clic here for more details about this article)

10/14. Trigemino-abducens synkinesis: an unusual case of aberrant regeneration.

    An unusual case of major head trauma is described involving injury to the right third, fifth, sixth and seventh cranial nerves in a basal skull fracture in a young woman. Two years later there persisted a total voluntary abducens nerve palsy, right facial hemianaesthesia and right temporalis and masseter palsy. However, involuntary abduction of the involved eye occurred on eating or chewing. electromyography of the lateral rectus muscle documented aberrant reinnervation to support the clinical findings. Extraocular muscle surgery improved the compensatory head posture and minimized the chewing-induced abduction. The mechanisms for acquired synkinesis and the anatomy of the involved nerves are reviewed. It is postulated that regenerating motor fibres of the trigeminal nerve were misdirected along proprioceptive channels to the lateral rectus in the case reported here.
- - - - - - - - - -
ranking = 4.8150026922096
keywords = skull fracture, fracture, skull
(Clic here for more details about this article)
| Next ->


Leave a message about 'Abducens Nerve Injury'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.