Multiple cranial nerve palsies with altitudinal hemianopsia following traumatic brain injury in remote area: A case report

Abstract

Cranial nerve injury (CNI) is a potential complication of traumatic brain injury (TBI). Diagnosis of CNI in TBI can be challenging and there is no consensus on the diagnosis and treatment of CN injury post TBI to date. We report a 49 year-old man who was admitted with a history of motorcycle accident and presented with headache, dizziness, and visual loss. Examination of his right eye showed oculomotor and trochlear nerve palsies with visual impairment and altitudinal hemianopsia. His head CT scan showed multiple cranial fractures. There was no improvement after methylprednisolone and antibiotic administration. Head trauma patients must undergo a routine comprehensive neurological and eye examinations. Further investigations are needed to evaluate the progression and impact of the head trauma that occurred.