Department of Neurology, Graduate School of Medicine, Nippon Medical School.
Department of Neurology, Shioda Hospital.
J Nippon Med Sch. 2021 Dec 29;88(6):561-563. doi: 10.1272/jnms.JNMS.2021_88-515. Epub 2021 Jan 16.
Ischemic stroke is a very rare etiology in cases of isolated trochlear nerve palsy, and no reports of ipsilateral trochlear nerve palsy caused by unilateral stroke have so far been published. However, we now report a case of isolated trochlear nerve palsy due to ipsilateral dorsal small midbrain infarction in a 70-year-old woman who presented with acute onset of diplopia. There were no other clinical manifestations, but brain magnetic resonance imaging revealed a small ischemic lesion in the right dorsal midbrain, showing that isolated trochlear nerve palsy can be caused by stroke.
孤立性滑车神经麻痹的病因中，脑梗死非常罕见，迄今为止，尚未有单侧脑梗死导致同侧滑车神经麻痹的报道。然而，我们现在报告了一例 70 岁女性孤立性滑车神经麻痹病例，其表现为急性复视。无其他临床表现，但脑磁共振成像显示右侧中脑背侧有小的缺血性病灶，表明孤立性滑车神经麻痹也可由脑梗死引起。
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