Clinical Practice and Cases in Emergency Medicine (Aug 2024)

Pupil Unleashed: Unraveling the Enigma of an Unusual Traumatic Head Injury: A Case Report

  • Akash Daswaney,
  • Shuchi Abhishek,
  • Sanjan Asanaru Kunju,
  • Priya Pattath Sankaran,
  • Ahlam Abdul Rahman

DOI
https://doi.org/10.5811/cpcem.20308
Journal volume & issue
Vol. 8, no. 3
pp. 282 – 286

Abstract

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Introduction: Isolated oculomotor nerve palsy after mild traumatic brain injury is unusual and prognostically significant due to unclear mechanisms and recovery challenges. We present a case of isolated oculomotor nerve palsy following minor head trauma, shedding light on this unusual occurrence. Case Report: A 24-year-old male experienced severe vision loss and right-sided oculomotor nerve palsy after a motor vehicle collision. Initial imaging showed a hemorrhagic focus in the left posterior fossa and a contusion in the corpus callosum, yet no direct cause for the nerve palsy was found. Partial recovery was observed after 12 months. Conclusion: This case underscores the importance of maintaining a heightened suspicion for occult intracranial findings, especially when the initial non-contrast computed tomography was inconclusive. Timely clinical assessment and appropriate radiological investigations by emergency physicians are crucial for improving the prognosis.