Mon Y
Department of Medicine, Ayabe Kyoritu Hospital.
Rinsho Shinkeigaku. 1996 Jan;36(1):71-3.
A case of midbrain hemorrhage with isolated trochlear nerve palsy was reported. A 70-year-old female noticed vertical diplopia of insidious onset. Ouclar motility was normal. But her diplopia increased with right head tilt and in the left downward gaze, and disappeared with left head tilt. She had no other neurological symptoms and signs. CT scan revealed high density spot in the left tectum of lower midbrain. This lesion decreased over months but small high density spot existed five months later, which means calcified lesion, probably vascular anomaly. This is the first stroke case of trochlear nerve palsy without other neurological symptoms and signs. The first reason this patient showed isolated trochlear nerve palsy is that hematoma was small. The second is that hematoma developed slowly.
报告了一例伴有孤立性滑车神经麻痹的中脑出血病例。一名70岁女性注意到隐匿起病的垂直性复视。眼球运动正常。但她的复视在向右侧头倾斜和向左下方注视时加重，而在向左头倾斜时消失。她没有其他神经症状和体征。CT扫描显示中脑下部左侧顶盖有高密度灶。该病灶在数月内缩小，但5个月后仍存在小的高密度灶，提示钙化灶，可能为血管异常。这是首例无其他神经症状和体征的滑车神经麻痹卒中病例。该患者出现孤立性滑车神经麻痹的首要原因是血肿较小。其次是血肿发展缓慢。
