Traumatic bilateral fourth nerve palsy: Double vision induced by downward gaze after head injury

J Gen Fam Med. 2020 Mar 11;21(4):155-156. doi: 10.1002/jgf2.310. eCollection 2020 Jul.

Abstract

Clinicians should be alert to traumatic fourth nerve palsy in patients with double vision after head injury. In most cases with traumatic fourth nerve palsy, the imaging tests fail to show abnormal findings. In the cases of bilateral superior oblique paresis, the sensitivity of Bielschowsky head-tilt test is 40%.

Keywords: concussion; double vision; fourth nerve palsy; head injury; trauma.