Document Detail

Ocular manifestations uncover chronic subdural hematoma secondary to abuse.
MedLine Citation:
PMID:  20152779     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An abduction deficit or cranial nerve VI palsy can have many potential etiologies. However, a cranial nerve VI palsy in the setting of disc edema suggests increased intracranial pressure, requiring emergent work-up. CASE REPORT: An 18-year-old woman presented with significant headaches and horizontal diplopia, which she claimed began after giving birth 3 months prior. Her examination found a right cranial nerve VI palsy and mild disc edema of the left eye. This combination of findings was suggestive of increased intracranial pressure. Emergent workup uncovered a large chronic subdural hematoma requiring immediate neurosurgical intervention. She ultimately admitted to being abused by her partner. CONCLUSION: Diplopia and disc edema in a young, nonoverweight patient with an altered mental state is very concerning. Meningitis and complications of spinal anesthesia, although rare, need to be considered in patients who have recently given birth. However, other causes of increased intracranial pressure, including subdural hemorrhage secondary to trauma, also have to be considered, even if the patient denies any history of trauma. Abused patients often deny trauma.
Kelly A Malloy; Degaulle I Chigbu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Optometry (St. Louis, Mo.)     Volume:  81     ISSN:  1558-1527     ISO Abbreviation:  Optometry     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100912421     Medline TA:  Optometry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-70     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.
Pennsylvania College of Optometry, at Salus University, Elkins Park, Pennsylvania.
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MeSH Terms
Abducens Nerve
Cranial Nerve Diseases / etiology
Craniocerebral Trauma / complications*
Diplopia / etiology*
Headache / etiology
Hematoma, Subdural, Chronic / etiology*
Ocular Motility Disorders / etiology*
Papilledema / etiology*
Spouse Abuse*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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