Isolated ONP in Mild TBI Is Rare but Diagnosable With CE-MRI

Background: Oculomotor nerve palsy (ONP) due to mild traumatic brain injury (TBI) is rare and can be difficult to diagnose. Since ONP is typically present in association with diffuse axonal injury (poor prognosis) and no demonstrated skull base fractures along the course of the 3 rd nerve and brainstem injuries, the diagnosis of isolated ONP in the absence of these findings can be challenging. Objective: To evaluate the utility of contrast-enhanced MRI (CE-MRI) for diagnosis of ONP cases in mild TBI patients. Design: Retrospective study. Methods: This retrospective analysis was conducted on 6 patients diagnosed with isolated ONP after mild TBI (with no skull base fractures along the course of the 3 rd nerve or brainstem findings). All patients underwent CE-MRI. Clinical presentations, imaging findings, and outcomes were documented and reviewed by a neuroradiologist. Results: CE-MRI findings of thickening, blooming, and post-contrast enhancement of the cisternal portion of the 3 rd cr more...