Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Department of Neurosurgery, Fukuoka University Hospital, Fukuoka, Japan.
Acta Neurochir (Wien). 2023 Apr;165(4):1027-1030. doi: 10.1007/s00701-023-05530-9. Epub 2023 Mar 3.
We describe a case of isolated trochlear nerve palsy caused by an unruptured posterior cerebral artery (PCA) aneurysm in an 82-year-old male who consulted an ophthalmologist after developing diplopia. Magnetic resonance angiography showed a left PCA aneurysm in the ambient cistern, and T2WI showed an aneurysm compressing the left trochlear nerve to the cerebellar tentorium. Digital subtraction angiography revealed that the lesion was located between the left P2a segment. We attributed this isolated trochlear palsy to left PCA unruptured aneurysm pressure. Thus, we performed stent-assisted coil embolization. The aneurysm was obliterated, and trochlear nerve palsy improved completely.
我们描述了一例 82 岁男性孤立性滑车神经麻痹病例，该患者因左眼复视而咨询眼科医生，其病因是未破裂的大脑后动脉（PCA）动脉瘤。磁共振血管造影显示左侧 PCA 在环池内有一个动脉瘤，T2WI 显示动脉瘤压迫左侧滑车神经至小脑幕。数字减影血管造影显示病变位于左侧 P2a 段之间。我们将这种孤立性滑车神经麻痹归因于左侧 PCA 未破裂的动脉瘤压迫。因此，我们进行了支架辅助线圈栓塞。动脉瘤被完全闭塞，滑车神经麻痹完全改善。
