Traumatic cranial neuropathies

Abstract

Many patients who sustain head trauma may have associated orbital injuries that necessitate a thorough, systematic ophthalmic evaluation. In patients with recent cranial injury, bedside testing may be diffi cult and limited. At times, the pupillary examination, forced duction testing, anterior segment examination, and direct ophthalmoscopy are all that are initially feasible. This information, along with imaging studies, guides much of the early treatment of head injury patients. Motor vehicle accidents are the most common cause of head trauma, and cranial nerve injuries occur in approximately 13% of these patients [1]. This chapter will discuss the diagnosis and management of traumatic injury to the optic nerve and the motor nerves of the orbit. Discussion of trigeminal and facial nerve injury is found in other chapters.