Localization of traumatic oculomotor nerve palsy to the midbrain exit site by magnetic resonance imaging

Am J Ophthalmol. 1996 Sep;122(3):437-9. doi: 10.1016/s0002-9394(14)72078-1.


Purpose: To present the magnetic resonance imaging findings for a patient with traumatic oculomotor nerve injury.

Methods: We examined a patient with a right pupil-involving oculomotor nerve palsy after severe closed head trauma.

Results: Magnetic resonance imaging of the brain demonstrated marked signal hypointensity on gradient-echo T2*-weighted images consistent with hemorrhage at the midbrain exit site of the right oculomotor nerve.

Conclusions: Distal fascicular damage or partial rootlet avulsion is a mechanism of injury in some traumatic oculomotor nerve palsies. Gradient-echo T2*-weighted magnetic resonance imaging is the most sensitive method to detect hemorrhagic changes associated with shearing injury.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Brain Injuries / diagnosis*
  • Cerebral Hemorrhage / diagnosis
  • Eye Injuries / diagnosis*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Mesencephalon / injuries*
  • Mesencephalon / pathology
  • Oculomotor Nerve / pathology
  • Oculomotor Nerve Diseases / diagnosis*
  • Oculomotor Nerve Injuries*
  • Pupil Disorders / diagnosis
  • Wounds, Nonpenetrating / diagnosis*