RESUMEN
Orbital apex syndrome is rare, but can occur as a consequence of trauma from fracture of the medial orbit. This case report highlights the fact that a high index of suspicion is needed when a patient presents with a facial injury, especially in children who cannot give an account of the actual events that transpired. Radiological investigation should be done early when an underlying injury is suspected in a trauma patient. A low threshold for computed tomography should be maintained when proptosis and vision loss are present.
Asunto(s)
Traumatismo del Nervio Abducente/diagnóstico , Diagnóstico Tardío , Traumatismos del Nervio Oculomotor/diagnóstico , Fracturas Orbitales/diagnóstico , Traumatismos del Nervio Trigémino/diagnóstico , Traumatismos del Nervio Troclear/diagnóstico , Traumatismo del Nervio Abducente/tratamiento farmacológico , Traumatismo del Nervio Abducente/etiología , Analgésicos/uso terapéutico , Antibacterianos/uso terapéutico , Blefaroptosis/etiología , Niño , Dexametasona/uso terapéutico , Exoftalmia/etiología , Hematoma/diagnóstico , Hematoma/etiología , Humanos , Masculino , Traumatismos del Nervio Oculomotor/tratamiento farmacológico , Traumatismos del Nervio Oculomotor/etiología , Nervio Oftálmico/lesiones , Oftalmología , Fracturas Orbitales/complicaciones , Trastornos de la Pupila/etiología , Radiografía , Derivación y Consulta , Síndrome , Tomografía Computarizada por Rayos X , Traumatismos del Nervio Trigémino/tratamiento farmacológico , Traumatismos del Nervio Trigémino/etiología , Traumatismos del Nervio Troclear/tratamiento farmacológico , Traumatismos del Nervio Troclear/etiología , Trastornos de la Visión/diagnóstico , Trastornos de la Visión/etiologíaRESUMEN
The incidence of primary traumatic oculomotor nerve palsies in craniocerebral trauma is approximately 1.2% and is usually persistent and associated with loss of consciousness, other neurologic deficits, and skull base or orbital fractures. This case is a rare demonstration of complete left third nerve palsy from uncal herniation after trauma without any loss of consciousness.