頭部外傷に起因する一次性両側動眼神経麻痺の1例

Bilateral Direct Injury of Oculomotor Nerves in Cranioccrebral Trauma:Report of a Case

Ⅰ．はじめに

　頭部外傷に由来する眼筋障害，眼球運動神経．麻痺には直達外力により受傷直後に発生する一次性障害と，脳ヘルニヤなどに起因する続発性の二次性障害に分けられる．これらの多くは内眼筋，外眼筋，あるいは眼瞼挙筋．眼輪筋などの片側性の部分もしくは複合障害であり，両側性のものはまれである．

　一次性両側眼球運動神経障害は少ないものであるが^{9，10，12，18）}，とりわけ両側性動眼神経麻痺が頭部外傷の一次性損傷としてみられたとの報告はまれである^{2，8，10，12，18）}．

A 46-year-old housewife was admitted to the Kawasaki Hospital soon after traffic accident. She was struck in the right ferehead. She was very slightly drowsy but well oriented. Both eyeballs were extremely abducted without any motility. The pupils were bilaterally dilated and equal in size with no response to light. There was a pronounced blephaloptosis on both sides. Another neurological abnormality was a slight right facial weakness. On skull films, a linear fracture in the right temporobasal region was noted but the views of the orbits were normal.