J Korean Ophthalmol Soc > Volume 57(11); 2016 > Article
Journal of the Korean Ophthalmological Society 2016;57(11):1812-1816.
DOI: https://doi.org/10.3341/jkos.2016.57.11.1812    Published online November 15, 2016.
A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia.
Hyun Ju Kee, Yung Ju Yoo, Jae Hyoung Kim, Hee Kyung Yang
1Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. nan282@snu.ac.kr
2Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
양안 복시로 나타난 도르래신경초종 1예
기현주1⋅류영주1⋅김재형2⋅양희경1
서울대학교 의과대학 분당서울대학교병원 안과학교실1, 서울대학교 의과대학 분당서울대학교병원 영상의학교실2
Abstract
PURPOSE
To report a case of unilateral trochlear nerve schwannoma in a patient without neurofibromatosis. CASE SUMMARY: A 58-year-old male presented with acute onset of diplopia which developed 10 days prior. Alternate prism cover test, ductions and versions and Bielschowsky three-step test were compatible with left superior oblique muscle palsy. High-resolution magnetic resonance imaging showed a 6-mm-sized lobulated mass in the cisternal segment of the left trochlear nerve passing lateral to the brainstem. An additional thin-section gadolinium-enhanced orbit magnetic resonance imaging showed definite enhancement in the entire portion of the lobulated mass, compatible with a trochlear nerve schwannoma. Diplopia was managed conservatively with prism glasses and regular follow-up examinations were recommended without further treatment. CONCLUSIONS: A trochlear nerve tumor should be considered in adults who develop diplopia associated with acquired superior oblique muscle palsy.
Key Words: Acquired superior oblique muscle palsy;Trochlear nerve schwannoma;Trochlear nerve tumor


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