Department of Ophthalmology, Duke Eye Center and Duke University Medical Center Durham, North Carolina, USA.
Department of Ophthalmology, Duke Eye Center and Duke University Medical Center Durham, North Carolina, USA; Department of Neurology, Duke Eye Center and Duke University Medical Center Durham, North Carolina, USA; Department of Neurosugery, Duke Eye Center and Duke University Medical Center Durham, North Carolina, USA.
Surv Ophthalmol. 2019 Sep-Oct;64(5):734-740. doi: 10.1016/j.survophthal.2018.06.005. Epub 2018 Jun 28.
Binocular diplopia and right hemifacial numbness developed in a 52-year-old woman after resection of a right temporal lobe glioblastoma. Based on the Parks-Bielschowsky 3-step test, she was diagnosed with a right cranial nerve (CN) IV palsy in addition to right CN V dysfunction. Iatrogenic diplopia may result from temporal lobe surgery due to the intimate relationship of CN IV and CN III to the mesial temporal lobe. In addition, injury to CN V within Meckel cave is believed to be the cause of facial numbness in some patients after temporal lobe surgery. The anatomy of the intracranial portion of CN IV is reviewed, and the etiologies of CN IV palsy are discussed.
一位 52 岁女性在切除右侧颞叶胶质母细胞瘤后出现双眼复视和右侧半面麻木。基于 Parks-Bielschowsky 三步测试，她被诊断为右侧颅神经 (CN) IV 麻痹，同时还存在右侧 CN V 功能障碍。由于 CN IV 和 CN III 与内侧颞叶关系密切，颞叶手术可能导致医源性复视。此外，一些患者在颞叶手术后出现面部麻木，被认为是 Meckel 腔内部的 CN V 损伤所致。本文回顾了 CN IV 颅内部分的解剖结构，并讨论了 CN IV 麻痹的病因。
