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At least 145 records · Page 8Linked to original sources
PubMed1977

Analysis of trochlear nerve palsies. Diagnosis, etiology, and treatment.

At the McGill University neuro-ophthalmology unit, 52 patients with superior oblique palsy were seen during the 2-year period October 1973 to August 1975; these included patients with congenital, traumatic, vascular, and other more rare causes of trochlear paralysis. Half of the patients with congenital palsy had diplopia, requiring treatment, although surgery was rarely necessary. Patients with palsy due to trauma, the major cause in our series, included four with bilateral involvement. With the exception of recovery in a single muscle of one patient in this group with traumatic palsy, no spontaneous recoveries have been observed. Treatment modalities have been tried, including observation alone, occlusion for symptomatic relief of diplopia, use of prisms, and recession of the ipsilateral inferior oblique muscle. Four patients with palsy of presumed vascular cause recovered spontaneously within a 4-month period. All patients who were surgically treated improved.

Adolescent↗
PubMed1981

Trochlear nerve palsy as a false localizing sign.

A 12-year-old boy developed a fourth nerve palsy during the course of pseudotumor cerebri syndrome. False or nonlocalizing signs that occur during the course of intracranial disease are briefly reviewed. The rarity of a fourth nerve palsy as a false localizing sign is pointed out. However, the question is raised whether a number of subtle fourth nerve palsies go unnoticed and that the true incidence of false localizing fourth nerve palsies is higher.

Child↗
PubMed1990

Left trochlear nerve palsy, unique symptom of an arachnoid cyst of the quadrigeminal plate. Case report.

An arachnoid cyst of the quadrigeminal plate in a 49-year-old female is reported. This is the seventh published case of a cyst of this kind in an adult. The presenting symptom was an isolated left fourth cranial nerve palsy. Up to now, no other case with isolated superior oblique muscle palsy has been described which was caused by an arachnoidal cyst of the quadrigeminal plate.

Arachnoid Cysts↗
PubMed1990

Hematoma of the inferior colliculus: uncommon cause of trochlear nerve deficit and contralateral sensory hemisyndrome.

A 57 year old man consulted us for sudden onset of acuphenes in the right ear, followed by diplopia on forward and downward gaze and paresthesias on the right side of the body. Examination of ocular movements revealed a deficit of the superior oblique muscle of the left eye. CT and MR brainscans imaged a punctate bleed of the left inferior colliculus. The patient was discharged after 16 days still complaining of diplopia on forward and downward gaze. There was no change in neurological status at follow-up. It is rare for an intracerebral hematoma to be located in the midbrain. The case we report is distinguished by the smallness of the lesion and the uncommon neurological deficit it caused.

Cerebral Hemorrhage↗
PubMed2003

Neurotization of oculomotor, trochlear and abducent nerves in skull base surgery.

OBJECTIVE: To anatomically reconstruct the oculomotor nerve, trochlear nerve, and abducent nerve by skull base surgery. METHODS: Seventeen cranial nerves (three oculomotor nerves, eight trochlear nerves and six abducent nerves) were injured and anatomically reconstructed in thirteen skull base operations during a period from 1994 to 2000. Repair techniques included end-to-end neurosuture or fibrin glue adhesion, graft neurosuture or fibrin glue adhesion. The relationships between repair techniques and functional recovery and the related factors were analyzed. RESULTS: Functional recovery began from 3 to 8 months after surgery. During a follow-up period of 4 months to 6 years, complete recovery of function was observed in 6 trochlear nerves (75%) and 4 abducent nerves (67%), while partial functional recovery was observed in the other cranial nerves including 2 trochlear nerves, 2 abducent nerves, and 3 oculomotor nerves. CONCLUSIONS: Complete or partial functional recovery could be expected after anatomical neurotization of an injured oculomotor, trochlear or abducent nerve. Our study demonstrated that, in terms of functional recovery, trochlear and abducent nerves are more responsive than oculomotor nerves, and that end-to-end reconstruction is more efficient than graft reconstruction. These results encourage us to perform reconstruction for a separated cranial nerve as often as possible during skull base surgery.

Abducens Nerve↗