Traumatic cranial neuropathy

Richard S Polin MD (Dr. Polin of George Washington University has no relevant financial relationships to disclose.)
Randolph W Evans MD, editor. (

Dr. Evans of Baylor College of Medicine received honorariums from Allergan, Amgen, Biohaven, Lilly, and Novartis for speaking engagements.

Originally released June 7, 1999; last updated May 2, 2020; expires May 2, 2023


Traumatic cranial neuropathies are often seen with fractures involving the skull base. They most frequently involve the olfactory and optic nerves at the anterior skull base or the seventh and eighth cranial nerves in the temporal bone. In this update, the author discusses updates on posttraumatic optic neuropathy.

Historical note and terminology

Samuel Thomas Soemmerring, a German medical student, established the present classification of cranial nerves in 12 numbered pairs 2 centuries ago. The basis of the classification was the different foramina in the base of the skull through which the nerves exit the cranial cavity (Rucker 1966). The first description of traumatic cranial nerve injury appears in the Edwin Smith Papyrus and describes a patient with a facial droop following head injury. The droop was on the same side as the fracture and was probably due to a contre-coup injury (Elsberg 1931).

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