{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:40Z","timestamp":1776096460780,"version":"3.50.1"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Even though head injury is one of the possible causes for oculomotor nerve palsy (ONP), it is uncommon to find an isolated ONP in a patient who sustained a traumatic brain injury (TBI). Both posttraumatic ONP and brainstem hemorrhage are more frequently seen in patients with severe TBI, and the overall outcome of ONP after head injury is poor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 53-year-old male patient presented after he was hit by a speeding car from behind while he crossing a road, and then he fell face first to the ground. His Glasgow Coma Scale score was 14 of 15. He had complete ONP of the left eye, but no other neurological abnormal findings. He had a midbrain hemorrhage on neuroimaging. On 6-month follow-up, the ptosis completely resolved, and the diplopia and eye movement showed partial recovery. However, the left pupil was still dilated and nonreactive to light.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Even though very rare, mild TBI can be associated with midbrain bleeding and an isolated ONP. The pattern of improvement of ONP starts from ptosis and then progresses to the extraocular muscles. The chance of recovery of pupillary size and reactivity to light is poor.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25741\">https:\/\/thejns.org\/doi\/10.3171\/CASE25741<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25741","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:30:00Z","timestamp":1770298200000},"source":"Crossref","is-referenced-by-count":0,"title":["An isolated oculomotor nerve palsy and brainstem hemorrhage in a 53-year-old male patient with mild traumatic brain injury: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Ermias F.","family":"Yesuf","sequence":"first","affiliation":[{"name":"Department of Surgery, Debre Berhan University, Debre Berhan City, Amhara State"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atiklet Z.","family":"Zewdie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Sheno Hospital, Sheno City, Oromia State"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohannes G.","family":"Zewdie","sequence":"additional","affiliation":[{"name":"Department of Radiology, Addis Ababa University, Addis Ababa City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alemu A.","family":"Mldie","sequence":"additional","affiliation":[{"name":"Department of Surgery, Jimma University, Jimma City, Oromia State"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henok T.","family":"Molla","sequence":"additional","affiliation":[{"name":"Department of Surgery, Addis Ababa University, Addis Ababa City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mestet Y.","family":"Shiferaw","sequence":"additional","affiliation":[{"name":"Department of Surgery, Injibara University, Injibara City, Amhara State, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"bib1","series-title":"Semin Neurol","first-page":"257","article-title":"Third nerve palsies","volume":"27","author":"Bruce","year":"2007","unstructured":"Bruce BBBiousse VNewman NJ.Third nerve palsies. 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J Forensic Leg Med. 2012;19(3):144-151."},{"issue":"8","key":"bib19","series-title":"J Clin Neurosci","first-page":"852","article-title":"Traumatic oculomotor nerve palsy","volume":"13","author":"Kaido","year":"2006","unstructured":"Kaido TTanaka YKanemoto YKatsuragi YOkura H.Traumatic oculomotor nerve palsy. J Clin Neurosci. 2006;13(8):852-855."},{"issue":"1","key":"bib20","series-title":"Brain Nerve","first-page":"89","article-title":"Primary oculomotor nerve palsy due to mild head injury: report of two cases","volume":"60","author":"Katsuno","year":"2008","unstructured":"Katsuno MKobayashi SYokota HTeramoto A.Primary oculomotor nerve palsy due to mild head injury: report of two cases. 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Curr Neurol Neurosci Rep. 2013;13(11):389."},{"issue":"9","key":"bib30","series-title":"No Shinkei Geka","first-page":"849","article-title":"Isolated infranuclear oculomotor nerve palsy caused by traumatic midbrain hemorrhage: case report","volume":"24","author":"Tokuno","year":"1996","unstructured":"Tokuno TKawakami YYamamoto T.Isolated infranuclear oculomotor nerve palsy caused by traumatic midbrain hemorrhage: case report. No Shinkei Geka. 1996;24(9):849-852."},{"issue":"4","key":"bib31","series-title":"Emerg Med J","first-page":"310","article-title":"Mild head injury with isolated third nerve palsy","volume":"18","author":"Muthu","year":"2001","unstructured":"Muthu PPritty P.Mild head injury with isolated third nerve palsy. Emerg Med J. 2001;18(4):310-311."},{"key":"bib32","series-title":"World Neurosurg","first-page":"296","article-title":"Ocular movement nerve palsy after mild head trauma","volume":"94","author":"Li","year":"2016","unstructured":"Li GZhu XGu XOcular movement nerve palsy after mild head trauma. World Neurosurg. 2016;94:296-302."},{"issue":"3","key":"bib33","series-title":"J Athl Train","first-page":"256","article-title":"Review of vestibular and oculomotor screening and concussion rehabilitation","volume":"52","author":"Kontos","year":"2017","unstructured":"Kontos APDeitrick JMCollins MWMucha A.Review of vestibular and oculomotor screening and concussion rehabilitation. J Athl Train. 2017;52(3):256-261."},{"issue":"5","key":"bib34","series-title":"J AAPOS","first-page":"510","article-title":"The role of botulinum toxin in management of acute traumatic third-nerve palsy","volume":"12","author":"Talebnejad","year":"2008","unstructured":"Talebnejad MRSharifi MNowroozzadeh MH.The role of botulinum toxin in management of acute traumatic third-nerve palsy. J AAPOS. 2008;12(5):510-513."},{"issue":"3","key":"bib1","series-title":"Semin Neurol","first-page":"257","article-title":"Third nerve palsies","volume":"27","author":"Bruce","year":"2007","unstructured":"Bruce BBBiousse VNewman NJ.Third nerve palsies. Semin Neurol. 2007;27(3):257-268."},{"key":"bib2","article-title":"DeJong\u2019s the Neurologic Examination","author":"Campbell","year":"2005","unstructured":"Campbell WWDeJong RN.DeJong\u2019s the Neurologic Examination. 6th ed. 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Acta Neurol Scand. 1964;40(4):375-385."},{"issue":"4","key":"bib28","series-title":"Am J Pathol","first-page":"525","article-title":"The pathogenesis of secondary brainstem hemorrhages as studied in an experimental model","volume":"47","author":"Klintworth","year":"1965","unstructured":"Klintworth GK.The pathogenesis of secondary brainstem hemorrhages as studied in an experimental model. Am J Pathol. 1965;47(4):525-536."},{"issue":"11","key":"bib29","series-title":"Curr Neurol Neurosci Rep","first-page":"389","article-title":"Neuro-ophthalmic deficits after head trauma","volume":"13","author":"Jacobs","year":"2013","unstructured":"Jacobs SMVan Stavern GP.Neuro-ophthalmic deficits after head trauma. 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