Guerrero A L, Onzáin J I, Martín J A, Blanco A, Moreta J A
Servicio de Neurocirugia, Hospital Virgen de la Vega, Salamanca.
Rev Neurol. 1996 Aug;24(132):982-4.
From the relevant literature, it would seem that the commonest single cause of lesion of the third cranial nerves is indirect, accompanying intracranial traumas. From multiple clinical observations however, it seems that many of these cases may be due to lesions of the mesencephalum which nevertheless have rarely been identified by current imaging techniques. Clinical case. We describe the clinical observation of isolated pupil involvement, attributed to a lesion of the Edinger-Westphal nucleus as a consequence of a mesencephalic haematoma in the context of closed craneo-encephalic trauma. In our review of the literature, we have not found any other such case.
We briefly review the most frequently involved mechanisms implicated in the genesis of lesions of the third cranial nerves at different sites and the different changes seen in the pupil in each case, together with the characteristics and pathogenesis of the lesions produced in the mesencephalum as a consequence of intracranial trauma. We emphasize the importance of our case as being the first time an isolated lesion of the Edinger-Westphal nucleus has been described in topographic relation to a mesencephalic haematoma.
从相关文献来看，第三颅神经损伤最常见的单一原因似乎是间接性的，伴随颅内创伤。然而，从众多临床观察来看，似乎其中许多病例可能是由于中脑病变所致，不过目前的成像技术很少能识别出这些病变。临床病例。我们描述了在闭合性颅脑创伤背景下，因中脑出血导致动眼神经核损伤而出现孤立性瞳孔受累的临床观察情况。在我们对文献的回顾中，未发现其他此类病例。
我们简要回顾了第三颅神经在不同部位损伤发生过程中最常涉及的机制，以及每种情况下瞳孔出现的不同变化，还有颅内创伤导致中脑产生病变的特征及发病机制。我们强调本病例的重要性，因为这是首次按局部解剖关系描述与中脑出血相关的孤立性动眼神经核损伤。
