{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T12:56:34Z","timestamp":1754398594161,"version":"3.41.0"},"reference-count":15,"publisher":"National Athletic Trainers' Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:sec>\n          <jats:title>Objective:<\/jats:title>\n          <jats:p>To present the case of a National Collegiate Athletic Association Division I men's lacrosse athlete with fourth cranial nerve injury as the result of a minor traumatic blow.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Background:<\/jats:title>\n          <jats:p>The athlete was struck on the right side of his head during a lacrosse game. On-field evaluation revealed no cervical spine involvement or loss of consciousness. He complained of headache and dizziness, with delayed reports of visual disturbance. Sideline visual acuity and cranial nerve screenings appeared within normal limits. Consultation with the team physician indicated that immediate referral to the emergency department was unnecessary.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Differential Diagnosis:<\/jats:title>\n          <jats:p>Concussion, third cranial nerve palsy, fourth cranial nerve palsy.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Treatment:<\/jats:title>\n          <jats:p>The certified athletic trainer safely removed the athlete from the playing field and monitored him on the sideline. After being seen by the team physician, the patient was referred to a neurologist, ophthalmologist, and finally a neuro-ophthalmologist before a definitive diagnosis was made. The palsy did not necessitate surgical intervention, resolving with conservative treatment. The athlete was able to return to full athletic ability at his preinjury level by 8\u00a0months postinjury.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Uniqueness:<\/jats:title>\n          <jats:p>Superior oblique palsy as the result of fourth cranial nerve injury is the most frequent isolated cranial nerve palsy; however, these palsies are often underdiagnosed by health professionals. Such palsies are uncommon within the athletic realm, making timely diagnosis even less likely.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions:<\/jats:title>\n          <jats:p>Cranial nerve palsy may present very subtly in patients. Therefore, on-field health care providers should be aware of the descriptions and types of compensations that signal nerve injury.<\/jats:p>\n        <\/jats:sec>","DOI":"10.4085\/1062-6050-45.4.407","type":"journal-article","created":{"date-parts":[[2011,1,11]],"date-time":"2011-01-11T22:14:09Z","timestamp":1294784049000},"page":"407-410","source":"Crossref","is-referenced-by-count":4,"title":["Fourth Cranial Nerve Palsy in a Collegiate Lacrosse Player: A Case Report"],"prefix":"10.4085","volume":"45","author":[{"given":"Jennifer L.","family":"Stiller-Ostrowski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"key":"i1062-6050-45-4-407-Brodal1","series-title":"Neurological Anatomy in Relation to Clinical Medicine","author":"Brodal, A.","year":"1981","unstructured":"Brodal, A.\n          \n          Neurological Anatomy in Relation to Clinical Medicine. New York, NYOxford University Press. 1981."},{"issue":"12","key":"i1062-6050-45-4-407-Keane1","series-title":"Neurology","first-page":"2439","article-title":"Fourth nerve palsy: historical review and study of 215 inpatients.","volume":"43","author":"Keane, J. R.","year":"1993","unstructured":"Keane, J. R.\n          \n          Fourth nerve palsy: historical review and study of 215 inpatients.\n          Neurology\n          1993. 4312:2439\u20132443."},{"issue":"3","key":"i1062-6050-45-4-407-McCrory1","series-title":"J Sci Med Sport","first-page":"340","article-title":"Consensus statement on concussion in sport\u2014the 3rd International Conference on Concussion in Sport held in Zurich, November 2008.","volume":"12","author":"McCrory, P.","year":"2009","unstructured":"McCrory, P., W.Meeuwisse, K.Johnston, et al. 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B.\n          \n          Core Text of Neuroanatomy. Baltimore, MDWilliams & Wilkins. 1991."},{"key":"i1062-6050-45-4-407-Martin1","series-title":"Neuroanatomy Text and Atlas","author":"Martin, J. H.","year":"2003","unstructured":"Martin, J. H.\n          \n          Neuroanatomy Text and Atlas. New York, NYMcGraw-Hill. 2003."},{"key":"i1062-6050-45-4-407-WilsonPauwels1","series-title":"Cranial Nerves: Anatomy and Clinical Comments","author":"Wilson-Pauwels, L.","year":"1998","unstructured":"Wilson-Pauwels, L., E. J.Akesson, and P. A.Stewart. Cranial Nerves: Anatomy and Clinical Comments. Philadelphia, PADecker. 1998."},{"issue":"4","key":"i1062-6050-45-4-407-Kawarai1","series-title":"Eur Neurol","first-page":"256","article-title":"Isolated trochlear nerve palsy due to a contusion at the trochlear nerve exit zone.","volume":"62","author":"Kawarai, T.","year":"2009","unstructured":"Kawarai, T., R.Tsuda, N.Saji, M.Tadano, H.Shimuzu, and Y.Kita. Isolated trochlear nerve palsy due to a contusion at the trochlear nerve exit zone.Eur Neurol2009. 624:256."},{"issue":"5","key":"i1062-6050-45-4-407-Brazis2","series-title":"Mayo Clin Proc","first-page":"501","article-title":"Palsies of the trochlear nerve: diagnosis and localization. Recent concepts.","volume":"68","author":"Brazis, P. W.","year":"1993","unstructured":"Brazis, P. W.\n          \n          Palsies of the trochlear nerve: diagnosis and localization. Recent concepts.\n          Mayo Clin Proc\n          1993. 685:501\u2013509."},{"key":"i1062-6050-45-4-407-Blumenfeld1","series-title":"Neuroanatomy Through Clinical Cases","author":"Blumenfeld, H.","year":"2002","unstructured":"Blumenfeld, H.\n          \n          Neuroanatomy Through Clinical Cases. Sunderland, MASinauer Associates. 2002."},{"key":"i1062-6050-45-4-407-Patten1","series-title":"Neurological Differential Diagnosis","author":"Patten, J.","year":"1996","unstructured":"Patten, J.\n          \n          Neurological Differential Diagnosis. London, United KingdomSpringer. 1996."},{"issue":"1","key":"i1062-6050-45-4-407-Garnham1","series-title":"Aust N Z J Ophthalmol","first-page":"31","article-title":"Botulinum toxin in fourth nerve palsies.","volume":"25","author":"Garnham, L.","year":"1997","unstructured":"Garnham, L., J. M.Lawson, D.O'Neill, and J. P.Lee. Botulinum toxin in fourth nerve palsies.Aust N Z J Ophthalmol1997. 251:31\u201335."},{"issue":"1","key":"i1062-6050-45-4-407-Rush1","series-title":"Arch Ophthalmol","first-page":"76","article-title":"Paralysis of cranial nerve III, IV, and VI: cause and prognosis in 1,000 cases.","volume":"99","author":"Rush, J. A.","year":"1981","unstructured":"Rush, J. A. and B. R.Younge. 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Surgery of bilateral superior oblique palsy.Ophthalmology1982. 895:484\u2013488."}],"container-title":["Journal of Athletic Training"],"original-title":[],"link":[{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/45\/4\/article-p407.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/45\/4\/407\/1455806\/1062-6050-45_4_407.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/45\/4\/article-p407.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/45\/4\/article-p407.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:41:08Z","timestamp":1749688868000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/45\/4\/article-p407.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7]]},"references-count":15,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-45.4.407","relation":{},"ISSN":["1062-6050"],"issn-type":[{"type":"print","value":"1062-6050"}],"subject":[],"published":{"date-parts":[[2010,7]]}}}