Eisenhut Felix, Gerner Stefan T, Goelitz Philipp, Doerfler Arnd, Seifert Frank
Department of Neuroradiology and Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany.
Radiol Case Rep. 2020 Dec 11;16(2):384-388. doi: 10.1016/j.radcr.2020.12.001. eCollection 2021 Feb.
Traumatic, isolated oculomotor nerve palsy is a rare clinical finding and only few reports demonstrate associated magnetic resonance imaging (MRI) findings. Here, we present the case of a 70-year-old woman with left-sided oculomotor nerve palsy following a mild head trauma due to an e-bike accident. Post-traumatic cerebral computed tomography revealed punctiform hemorrhage in the left interpeduncular cistern and the following MRI confirmed an intraneural hemorrhage of the left oculomotor nerve. Nine weeks later, the follow-up MRI showed progressive atrophy and contrast-enhancement of the left oculomotor nerve. To support functional recovery, a treatment with intravenous corticosteroids was started. Six months later, the patient presented with improved oculomotor nerve function and partial recovery of ptosis and diplopia. In accordance, MRI demonstrated recurrent contrast-enhancement of the atrophic nerve. In conclusion, high-resolution MRI allows the reliable delineation of the oculomotor nerve and can support diagnosis in trauma patients with isolated oculomotor nerve palsy.
创伤性孤立性动眼神经麻痹是一种罕见的临床发现，仅有少数报告展示了相关的磁共振成像（MRI）结果。在此，我们报告一例70岁女性病例，她因电动自行车事故导致轻度头部外伤后出现左侧动眼神经麻痹。创伤后脑计算机断层扫描显示左侧脚间池点状出血，随后的MRI证实左侧动眼神经存在神经内出血。九周后，随访MRI显示左侧动眼神经出现进行性萎缩和强化。为促进功能恢复，开始静脉注射皮质类固醇治疗。六个月后，患者动眼神经功能改善，上睑下垂和复视部分恢复。相应地，MRI显示萎缩神经再次出现强化。总之，高分辨率MRI能够可靠地显示动眼神经，有助于诊断孤立性动眼神经麻痹的创伤患者。
