Case report: isolated trochlear nerve palsy associated with posterior cerebral artery aneurysm

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 a...

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Published inActa neurochirurgica Vol. 165; no. 4; pp. 1027 - 1030
Main Authors Yoshinaga, Taisuke, Fukumoto, Hironori, Kawano, Dai, Kobayashi, Hiromasa, Fukuda, Kenji, Morishita, Takashi, Inoue, Tooru, Abe, Hiroshi
Format Journal Article
LanguageEnglish
Published Vienna Springer Vienna 01.04.2023
Springer Nature B.V
Subjects
Aged, 80 and over
Aneurysm
Aneurysms
Angiography
Case Report
Case reports
Cerebellum
Diplopia
Embolization
Embolization, Therapeutic
Endovascular coiling
Humans
Hypertension
Implants
Interventional Radiology
Intracranial Aneurysm - complications
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - therapy
Magnetic Resonance Angiography
Magnetic resonance imaging
Male
Medical imaging
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Neurological disorders
Neurology
Neuroradiology
Neurosurgery
Paralysis
Posterior Cerebral Artery - diagnostic imaging
Stents
Surgical Orthopedics
Trochlear nerve
Trochlear Nerve Diseases - complications
Trochlear Nerve Diseases - etiology
Veins & arteries
Isolated trochlear nerve palsy
Posterior cerebral artery aneurysm
Stent-assisted coil embolization
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Summary: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. We attributed this isolated trochlear palsy to left PCA unruptured aneurysm pressure. Thus, we performed stent-assisted coil embolization. The aneurysm was obliterated, and trochlear nerve palsy improved completely.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
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ISSN:0942-0940
0001-6268
0942-0940
DOI:10.1007/s00701-023-05530-9