Department of Ophthalmology, Kellogg Eye Center, Ann Arbor, MI 48105, USA.
J Neuroophthalmol. 2010 Mar;30(1):59-63. doi: 10.1097/WNO.0b013e3181ce1b1d.
A 21-year-old man who suffered a traumatic brain injury from a motor vehicle accident recovered brain function except for an isolated left fourth cranial nerve palsy. Brain CT showed a focal hemorrhage in the right dorsal midbrain, directly in the brainstem path of what would become the left fourth cranial nerve. Although there has been previous imaging documentation of midbrain and cisternal hemorrhage in patients with isolated post-traumatic fourth cranial nerve palsy, this is the first report to show a large midbrain hemorrhage on CT. The mechanism is likely to be concussive impact of the dorsal midbrain on the tentorium cerebelli.
一名 21 岁男子因车祸导致外伤性脑损伤，除孤立性左侧第四颅神经麻痹外，大脑功能已恢复。脑 CT 显示右中脑背侧有局灶性出血，直接位于将成为左侧第四颅神经的脑干路径上。尽管以前有影像学记录表明孤立性创伤性第四颅神经麻痹患者存在中脑和脑池出血，但这是首次在 CT 上报告显示大量中脑出血。其机制可能是中脑背侧对小脑幕的震荡性冲击。
