The initial sign of parasellar or clival tumor in three patients was an oculomotor palsy precipitated by a mild blow to the head, insufficient to cause fracture or loss of consciousness. Oculomotor nerves stretched over the tumor or partially encased and fixed by the tumor are vulnerable to sudden mechanical stress. Palsy of these nerves from a subconcussive blow is rare—when it does occur, we believe it dictates investigation for basal tumor.
Eyster EF, Hoyt WF, Wilson CB. Oculomotor Palsy From Minor Head TraumaAn Initial Sign of Basal Intracranial Tumor. JAMA. 1972;220(8):1083–1086. doi:10.1001/jama.1972.03200080027006