A Case of Bilateral Trochlear Nerve Palsy Following Cisternography
Journal of the Korean Ophthalmological Society
; : 155-160, 2014.
Article
ي Ko
| WPRIM
| ID: wpr-28132
المكتبة المسؤولة:
WPRO
ABSTRACT
PURPOSE:
To report a case of bilateral trochlear nerve palsy following cisternography. CASESUMMARY:
A 43-year-old male with intermittent watery rhinorrhea persisting for 3 months visited the neurosurgery department of our institute. His past medical history included removal of a pituitary adenoma 22 years prior to presentation. Cerebrospinal fluid leakage was suspected and cisternography was performed. The patient was referred to our ophthalmology department for diplopia 3 days after the cisternography. An alternate prism cover test showed 5 prism diopter (PD) right hypertrophia in the primary position, and underaction of bilateral superior oblique muscles and overaction of the left inferior oblique muscle. A positive Bielschowsky test with the head tilted to either side was observed and excyclotorsion was 9degrees on the double Maddox rod test. The patient was diagnosed with bilateral trochlear nerve palsy. After 2 years of follow-up, diplopia persisted and recession of the bilateral inferior oblique muscles was performed. After the surgery, diplopia disappeared, the fundus photography showed no excyclotorsion, and the double Maddox rod test indicated 3degrees of excyclotorsion.CONCLUSIONS:
Cisternography should be carefully performed due to the possibility of bilateral trochlear nerve palsy, an extremely rare but possible occurrence following the procedure.Key words
النص الكامل:
1
الفهرس:
WPRIM
الموضوع الرئيسي:
Ophthalmology
/
Pituitary Neoplasms
/
Spinal Puncture
/
Trochlear Nerve
/
Photography
/
Cerebrospinal Fluid
/
Follow-Up Studies
/
Trochlear Nerve Diseases
/
Diplopia
/
Head
نوع الدراسة:
Observational_studies
/
Prognostic_studies
المحددات:
Adult
/
Humans
/
Male
اللغة:
Ko
مجلة:
Journal of the Korean Ophthalmological Society
السنة:
2014
نوع:
Article