A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia.
10.3341/jkos.2016.57.11.1812
- Author:
Hyun Ju KEE
1
;
Yung Ju YOO
;
Jae Hyoung KIM
;
Hee Kyung YANG
Author Information
1. Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. nan282@snu.ac.kr
- Publication Type:Case Report
- Keywords:
Acquired superior oblique muscle palsy;
Trochlear nerve schwannoma;
Trochlear nerve tumor
- MeSH:
Adult;
Brain Stem;
Diplopia*;
Eyeglasses;
Follow-Up Studies;
Glass;
Humans;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Neurilemmoma*;
Neurofibromatoses;
Orbit;
Paralysis;
Telescopes*;
Trochlear Nerve*
- From:Journal of the Korean Ophthalmological Society
2016;57(11):1812-1816
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of unilateral trochlear nerve schwannoma in a patient without neurofibromatosis. CASE SUMMARY: A 58-year-old male presented with acute onset of diplopia which developed 10 days prior. Alternate prism cover test, ductions and versions and Bielschowsky three-step test were compatible with left superior oblique muscle palsy. High-resolution magnetic resonance imaging showed a 6-mm-sized lobulated mass in the cisternal segment of the left trochlear nerve passing lateral to the brainstem. An additional thin-section gadolinium-enhanced orbit magnetic resonance imaging showed definite enhancement in the entire portion of the lobulated mass, compatible with a trochlear nerve schwannoma. Diplopia was managed conservatively with prism glasses and regular follow-up examinations were recommended without further treatment. CONCLUSIONS: A trochlear nerve tumor should be considered in adults who develop diplopia associated with acquired superior oblique muscle palsy.
