Injury of the oculomotor nerve in a patient with traumatic brain injury: Diffusion tensor tractography study

摘要

A 24-year-old female who had suffered a pedestrian traffic accident underwent conservative management for traumatic diffuse axonal injury at the Department of Neurosurgery in a University Hospital. The patient showed a stuporous mental state at admission and the patient's Glasgow Coma Scale score was 9 at that time. Brain MRI performed at 7 weeks from onset showed leukomalactic lesions in the body, isthmus and splenium of the corpus callosum (figure 1A). Her right eyelid showed complete ptosis, and her right eye was deviated outward and downward in primary position. She was not able to move her eyes in any direction, except for abduction, and her right pupil was dilated and non-reactive to light.Diffusion tensor imaging (DTI), a form of diffusion-weighted MRI that can be used for reconstruction of images of neural tracts, was acquired at 7 weeks after onset using a six-channel head coil on a 1.5T Philips Gyroscan Intera (Philips, Ltd, Best, the Netherlands) with single-shot echo-planar imaging.