J Korean Ophthalmol Soc > Volume 55(4); 2014 > Article
Journal of the Korean Ophthalmological Society 2014;55(4):596-601.
DOI: https://doi.org/10.3341/jkos.2014.55.4.596    Published online April 15, 2014.
Associated Injuries and Prognosis in Traumatic Isolated 3rd, 4th, and 6th Cranial Nerve Palsies.
Ji Seong Jeong, Dae Hyun Kim
Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea. eyekim@chosun.ac.kr
외상성 3, 4, 6번 단독뇌신경마비의 동반손상과 예후
정지성⋅김대현
Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea
Abstract
PURPOSE
To analyze the relationship between prognosis and the severity of associated injuries in traumatic isolated 3rd, 4th and 6th cranial nerve palsies. METHODS: The records of 39 patients (39 eyes) who were diagnosed with isolated 3rd, 4th or 6th cranial nerve palsy following trauma were reviewed retrospectively to analyze the etiology of trauma, the degree of associated injuries, the degree of paralysis, and the prognosis. RESULTS: The 4th cranial nerve was affected most frequently (19 patients, 48.7%), followed by the 6th nerve (12 patients, 30.8%) and the 3rd nerve (8 patients, 20.5%). Traffic accidents were the most frequent etiology of traumatic cranial nerve palsies. Loss of consciousness, intracranial hemorrhage, craniofacial fracture, c-spine injury, and optic nerve injury were among the most common accompanying conditions. The 3rd cranial nerve was the most severely paralyzed and showed the highest number of associated injuries. The recovery rate of the all cranial nerve palsies was 46.2%. By nerve, the 3rd cranial nerve palsy showed the lowest recovery rate of 25%, followed by the 4th nerve at 47.4%, and the 6th nerve at 58.3%. CONCLUSIONS: The prognosis was worse in patients with intracranial hemorrhage, compared with those without intracranial hemorrhage. There was a higher average number of associated injuries and the degree of paralysis was more severe in 3rd nerve palsies.
Key Words: Cranial nerve palsy;Intracranial hemorrhage;Trauma


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