An illustrative case highlights brainstem hemorrhage causing isolated oculomotor nerve palsy, indicating rare traumatic injury effects.
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. https://thejns.org/doi/10.3171/CASE25741.
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Yesuf et al. (2026) studied this question.
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