1,076 results match your criteria: "Trochlear Nerve Palsy"

Objective: This study aimed to clarify the symptoms of pituitary or parasellar tumor onset with cranial nerve palsy (CNP) and to improve our knowledge of this rare symptom and its most appropriate treatment.

Methods: Among 1281 patients with pituitary or parasellar tumors surgically treated from 2003 to 2020, 30 cases (2.34%; 15 men and 15 women; mean age: 55.

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Article Synopsis
  • Facial feminization surgery (FFS) is commonly performed on individuals experiencing gender dysphoria, focusing on altering facial contours, especially around the forehead and nose.
  • Rarely reported complications can occur, particularly relating to eye movement concerns after the surgery.
  • This article discusses two specific cases of superior oblique palsy, a condition leading to double vision, resulting from potential surgical trauma during the procedure, with differing treatment approaches for each case.
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There are many lesions that cause compression of nerves and vessels in the head and neck, and they can often be overlooked in the absence of adequate history or if not suspected by the radiologist. Many of these lesions require a high index of suspicion and optimal positioning for imaging. While a multimodality approach is critical in the evaluation of compressive lesions, an MRI utilizing high-resolution (heavily weighted) T2-weighted sequence is extremely useful as a starting point.

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Objectives: To evaluate the effect of inferior oblique (IO) myectomy on ocular torsion according to the absence of the trochlear nerve in unilateral congenital superior oblique palsy (UCSOP).

Methods: We retrospectively reviewed the clinical data of patients who had been diagnosed with UCSOP and underwent ipsilateral IO myectomy (n = 43). Patients were classified into the present and absent groups according to the absence of the trochlear nerve and superior oblique hypoplasia on magnetic resonance imaging (MRI).

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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.

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The majority of arachnoid cysts are congenital intracranial lesions that develop in the early embryonic stages as a result of a slight irregularity in the cerebrospinal fluid's (CSF) passage through the embryonic mesenchyme. Most of the time, these cysts are asymptomatic all throughout life. Diplopia caused by an arachnoid cyst is extremely rare.

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Myositis of the superior oblique muscle in a patient with suspected superior oblique muscle palsy.

J AAPOS

April 2023

Department of Ophthalmology, College of Medicine, Soonchunhyang University, Cheonan, Korea. Electronic address:

Orbital myositis comprises a subtype of idiopathic orbital inflammation. Symptoms and clinical signs include orbital pain, eyelid swelling, ptosis, and conjunctival chemosis, sometimes concurrent with diplopia. Orbital myositis typically occurs in an idiopathic acute form and affects one or more extraocular muscles.

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Background: Neurovascular compression syndromes (NVCSs) are a group of neurological disorders characterized by compression of a cranial nerve and include trigeminal neuralgia (TN), hemifacial spasm, geniculate neuralgia, glossopharyngeal neuralgia, vestibular paroxysmia, and trochlear palsy. The European Academy of Neurology recommends constructive interference in steady-state/fast imaging employing steady-state (CISS/FIESTA) magnetic resonance imaging (MRI) in the evaluation of medically intractable TN, but similar recommendations do not exist for the remaining NVCSs.

Methods: We conducted a retrospective chart review of 300 patients with an NVCS who underwent microvascular decompression (MVD) by a single neurosurgeon from 2004 to 2021.

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[Just a trochlear nerve palsy?].

Ophthalmologie

June 2023

Klinik und Poliklinik für Augenheilkunde, Justus-Liebig-Universität Gießen, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Friedrichstr. 18, 35392, Gießen, Deutschland.

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Disseminated tuberculosis masquerading as Tolosa-Hunt syndrome in initial presentation: A case report with literature review.

Radiol Case Rep

March 2023

Infectious Diseases Division, Department of Internal Medicine, Hamad Medical Corporation, Al Rayyan Rd., PO Box: 3050, Doha, Qatar.

Tolosa-Hunt syndrome (THS) is a painful ophthalmoplegia due to non-specific granulomatous inflammation in the cavernous sinus region. It is diagnosed by the International Classification of Headache Disorders (ICHD)-3 criteria. We report the case of a young lady who presented with a right-sided headache for 2 weeks, followed by right-sided diplopia for 4 days.

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Ocular nerve palsies are among the most common cranial neuropathies in neurological practice. Nerves can get affected anywhere along their path from the brainstem to the orbit. There can be isolated involvement of multiple cranial nerves together.

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Purpose: To describe the neuroanatomical correlates of unilateral congenital isolated oculomotor palsy by means of high-resolution MRI.

Methods: Children with a clinical diagnosis of congenital isolated oculomotr palsy and with a high-resolution MRI acquisition targeted on the orbits and cranial nerves were selected and included in the study. An experienced pediatric neuroradiologist evaluated all the exams, assessing the integrity and morphology of extraocular muscles, oculomotor, trochlear and abducens nerves as well as optic nerves and globes.

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Cranial Polyneuropathy Secondary to Remote Iophendylate Myelography.

Neuroophthalmology

March 2022

School of Medicine, From the Wilmer Eye Institute, the Johns Hopkins University, Baltimore, Maryland, USA.

A 68-year-old woman with controlled hypertension, and degenerative joint disease of the spine for which she had undergone several myelograms and three surgeries 30-32 years earlier, presented with a 2 year history of painless, oblique, binocular diplopia. Her prior ophthalmic evaluations were consistent with an isolated left trochlear nerve paresis. She had magnetic resonance imaging (MRI) showing multiple foci of T1-weighted hyperintensities around the midbrain and brainstem thought to represent subarachnoid fat from a ruptured dermoid cyst.

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Simultaneous oculomotor and trochlear nerve palsy in Herpes Zoster Ophthalmicus (HZO) is rare. We report a 78-year-old lady who presented with right ptosis while receiving treatment for HZO keratouveitis. Examination showed crusted vesicular lesions on the right V dermatome with right complete ptosis and limited right eye extraocular movement on adduction, supraduction, infraduction, and intorsion.

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Introduction: There are various etiologies for isolated third, fourth and sixth cranial nerve palsies. The most common etiology in adults aged 50 years and older with vascular risk factors such as diabetes, hyperlipidemia, and hyperlipidemia, is microvascular ischemia. The role of early neuroimaging in older patients with vascular risk factors presenting with acute isolated ocular motor nerve palsy is controversial.

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Ocular Motor Nerve Palsy After Traumatic Brain Injury: A Claims Database Study.

J Neuroophthalmol

March 2023

Department of Ophthalmology (HH, SRL), Stanford University School of Medicine, Palo Alto, California; and Department of Ophthalmology (HH), Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.

Background: Traumatic brain injury (TBI) is one of the common causes of ocular motor nerve (oculomotor nerve [CN3], trochlear nerve [CN4], and abducens nerve [CN6]) palsies, but there has been no large study of ocular motor nerve palsy caused by TBI. This study aimed to investigate the characteristics of and differences in ocular motor nerve palsy after TBI, according to patient age and severity of TBI.

Methods: This was a population-based retrospective cohort study that included patients who had ocular motor nerve palsy after TBI with ≥6 months of continuous enrollment using claims data from the IBM MarketScan Research Databases (2007-2016).

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The authors report two cases of an abducens palsy and a trochlear nerve palsy, respectively, in two patients who received a coronavirus disease 2019 (COVID-19) vaccine 2 weeks previously. Given the lack of other symptoms, normal test results, and spontaneous resolution of the diplopia, a likely association with the COVID-19 vaccine was suggested. .

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Can Binocular Alignment Distinguish Hypertropia in Sagging Eye Syndrome From Superior Oblique Palsy?

Invest Ophthalmol Vis Sci

September 2022

Department of Ophthalmology, University of California, Los Angeles, California, United States.

Purpose: Although the three-step test (3ST) is typically used to diagnose superior oblique palsy (SOP), sagging eye syndrome (SES) has clinical similarities. We sought to determine if alignment measurements can distinguish unilateral SOP from hypertropia in SES.

Methods: We studied hypertropic subjects who underwent surface-coil magnetic resonance imaging (MRI) demonstrating either SO cross-section reduction indicative of congenital or acquired palsy (SOP group) or lateral rectus muscle sag (SES group).

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