Unusual delayed presentation of head trauma complicating outcome of facial nerve decompression surgery

Abstract

Late presentation of head trauma is rare. A young boy presented with a traumatic facial paralysis after head trauma. A CT scan of the head showed temporal bone fracture without intracranial insult. Facial nerve decompression was performed and paralysis started improving. However, he presented with vertigo and sensorineural hearing loss after 2 months. Clinical examination also showed cerebellar sign. We suspected iatrogenic injury to the cochlea; however, brain MRI showed haemorrhage in the area of anterior inferior cerebellar artery. The patient was managed conservatively and the vertigo improved. This case stresses on unusual late presentation of head trauma and cerebellar artery injury that complicated the outcome of facial nerve paralysis.