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NR. 3/2005
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Uszkodzenia nerwów
II, III, IV, VI, VII po zamkniętych urazach głowy
Damage to the Cranial Nerves II, III, IV, VI, VII following
Closed Head Trauma
Anna Kubatko-Zielińska, Anna
Piwowarczyk, Mirosław Czarnocki, Bożena Romanowska-Dixon, Anna
Klonowska, Małgorzata Werenowska-Pietrzyk, Monika Gedliczka
Katedra i Klinika Okulistyki Collegium Medicum Uniwersytetu
Jagiellońskiego w Krakowie
Pracownia Patofizjologii Widzenia i Neurookulistyki
Kierownik: dr hab. n. med. Bożena Romanowska-Dixon |
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| Summary: |
Purpose of the
study was to assess the frequency of cranial nerves
damage (II, III, IV, V,VII) following head trauma and to
examine, how often patients with those palsies required
surgical treatment.
Material and methods: In our study we examined 71
patients, 18 women and 53 men at the age of 7-71 years (mean
33.3 years). Patients were treated between 1989-2004 for
cranial nerve damage following head trauma. All patients
underwent ophthalmic examination. Patients with
diagnosed orbit fracture were excluded from our study.
Results: In 28 cases we observed damages
involving IV nerve, in 25 - III nerve, in 19 - VI and in
5 cases - II and in 5 cases - VII nerve. Most patients
demonstrated isolated nerve damage, 12 presented 2 or 3
nerve damage ipisilaterally and in 3 cases - bilateral
palsy was observed. Diplopia was observed in all cases
with oculomotor nerve palsy. Four patients had diplopia
following decompensated heterophory. In most cases of
motor nerve palsies we observed improvement after
conservative treatment (n. IV 75%, n. III 60%, n. VI
37%). Several patients were treated with botulinum toxin
A, usually in the third month of palsy. Surgical
treatment was required in IV nerve damage in 11%, III
nerve in 12%, in VI nerve in 11%.
Conclusions: It was road accidents and fights
that were the most common cause of cranial nerve damages.
In most cases of III, IV, VI, VII nerves palsies we
observed improvement after conservative treatment, 10%
of patients with oculomotory nerves lesions required
surgical treatment. |
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| Key words: |
posttraumatic II, III, IV,
VI, VII nerves damage, conservative treatment, surgical
treatment. |
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