Sürücü Oguzkan, Sure Ulrich, Mittelbronn Michel, Meyermann Richard, Becker Ralf
Department of Neurosurgery, University of Marburg, Germany.
Clin Neurol Neurosurg. 2007 Nov;109(9):791-3. doi: 10.1016/j.clineuro.2007.06.005. Epub 2007 Jul 31.
Here we present the case of a 53-year old man with progressive double vision due to isolated left trochlear nerve palsy. Cranial magnetic resonance imaging (MRI) showed a small tumor within the left quadrigeminal cistern that did not increase in size after several months. Explorative neurosurgical intervention revealed a left trochlear nerve cavernoma. The lesion was microsurgically excised followed by end-to-end anastomosis of the trochlear nerve. After a one-year follow up, double vision totally disappeared and cranial MRI showed no recurrence. Cerebral cavernous malformations usually become symptomatic in seizures or focal neurological deficits after intracerebral hemorrhage. Rarely, cavernomas arise from cranial nerves. To the authors' knowledge, this is the first report on a symptomatic cavernous malformation arising from the trochlear nerve and on its successful surgical management.
在此，我们报告一例53岁男性因孤立性左侧滑车神经麻痹导致进行性复视的病例。头颅磁共振成像（MRI）显示左侧四叠体池内有一个小肿瘤，数月后大小未增加。探索性神经外科手术干预发现为左侧滑车神经海绵状血管瘤。该病变经显微手术切除，随后对滑车神经进行端端吻合。经过一年的随访，复视完全消失，头颅MRI显示无复发。脑海绵状畸形通常在脑出血后以癫痫发作或局灶性神经功能缺损为症状。海绵状血管瘤很少起源于颅神经。据作者所知，这是首例关于滑车神经起源的有症状海绵状畸形及其成功手术治疗的报告。
