Isolated third nerve palsy due to mesencephalic hematoma

Abstract

Isolated cranial nerve palsy is an uncommon sequel in head injury. A 9-year-old child was admitted in comatose condition after falling from a house with right pupil dilatation and same eyeball deviated laterally. Clinical impression was that of a right sided traumatic hematoma and resulting uncal herniation leading to third nerve palsy. However, CT scan revealed a small hemorrhage in anterior tegmentum on right side. The majority of third nerve palsies following trauma have been reported due to lateral herniation syndrome but isolated third nerve palsy due to tegmental herniation is rare entity.

Keywords

• tegmentum
• hematoma
• third nerve