Department of Ophthalmology (JP), University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, Florida; Department of Radiation Oncology (EAM, TPD), University of Miami Miller School of Medicine, Miami, Florida; Department of Hematology/Oncology (LGF), University of Miami Miller School of Medicine, Miami, Florida; Department of Radiology (GMS), University of Miami Miller School of Medicine, Miami, Florida; Department of Neurosurgery (RJK), University of Miami Miller School of Medicine, Miami, Florida.
J Neuroophthalmol. 2021 Mar 1;41(1):e134-e135. doi: 10.1097/WNO.0000000000000902.
An 81-year-old man with a history of metastatic melanoma presented with sudden onset of painless, binocular vertical diplopia. The clinical examination was consistent with a right fourth nerve palsy. An MRI of the head revealed a mass dorsal to the right tectum at the level of the inferior colliculus. An MRI just 4 months prior did not show a lesion in that location. An MRA of the head did not show an aneurysm. This is a rare case of an isolated fourth nerve palsy believed to be due to metastatic melanoma compressing the nerve along the dorsal midbrain.
一位 81 岁男性，有转移性黑色素瘤病史，突发无痛性双眼垂直复视。临床检查符合右侧第四颅神经麻痹。头部 MRI 显示在靠近下丘的右侧顶盖背侧有一肿块。仅仅 4 个月前的 MRI 检查并未显示该部位有病变。头部 MRA 也未发现动脉瘤。这是一例罕见的孤立性第四颅神经麻痹病例，据信是由于转移性黑色素瘤沿着中脑背侧压迫神经所致。
