Keane J R
Department of Neurology, Los Angeles County/University of Southern California Medical Center.
Neurology. 1993 Dec;43(12):2439-43. doi: 10.1212/wnl.43.12.2439.
A review of inpatient trochlear nerve pareses diagnosed over 23 years revealed head trauma as the principal cause, with surgical injury, inflammation, and brain tumors seen occasionally. Ischemic (microvascular) neuropathies were rare. About one-half of the patients (52%) had no other neuro-ophthalmologic signs, but only 5% were truly isolated, without other neurologic or ophthalmologic signs or symptoms. Fourth nerve palsies are underdiagnosed on hospital services, where stuporous patients encounter unsuspecting physicians.
一项对23年间诊断出的住院滑车神经麻痹病例的回顾显示，头部外伤是主要病因，偶尔可见手术损伤、炎症和脑肿瘤。缺血性（微血管）神经病变罕见。约一半患者（52%）无其他神经眼科体征，但仅有5%为真正孤立性病例，无其他神经或眼科体征或症状。在医院科室中，滑车神经麻痹常被漏诊，因为昏迷患者常被毫无戒心的医生忽视。
