Bilateral internuclear ophthalmoplegia and clivus fracture following head injury: case report

Internuclear ophthalmoplegia is a remarkable finding, particularly in patients victims of head injury. The medial longitudinal fasciculus, which is believed to be lesioned in cases of internuclear ophthalmoplegia, has an unique brain stem position and the mechanism involved in brain stem contusions...

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Bibliographic Details
Published in:Arquivos de neuro-psiquiatria 2002-09, Vol.60 (3-A), p.636-638
Main Authors: Bonilha, Leonardo, Fernandes, Yvens Barbosa, Mattos, João Paulo de Vasconcelos, Borges, Wilson Adriano Abraão, Borges, Guilherme
Format: Article
Language:English
Subjects:
Adult
clivus fracture
Cranial Fossa, Posterior - injuries
Craniocerebral Trauma - complications
head injury
Humans
internuclear ophthalmoplegia
Magnetic Resonance Imaging
Male
NEUROSCIENCES
Ophthalmoplegia - etiology
PSYCHIATRY
skull base
Skull Fractures - complications
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Summary:Internuclear ophthalmoplegia is a remarkable finding, particularly in patients victims of head injury. The medial longitudinal fasciculus, which is believed to be lesioned in cases of internuclear ophthalmoplegia, has an unique brain stem position and the mechanism involved in brain stem contusions implies a maximal intensity of shearing forces on the skull base. We describe a very rare association of bilateral ophthalmoplegia and clivus fracture following head injury, without further neurological signs. The patient history, his physical examination and the image investigation provide additional evidence to some of the mechanisms of injury proposed to explain post-traumatic internuclear ophthalmoplegia.
ISSN:0004-282X
1678-4227
0004-282X
1678-4227
DOI:10.1590/S0004-282X2002000400023