J Korean Ophthalmol Soc.  2016 Nov;57(11):1812-1816. 10.3341/jkos.2016.57.11.1812.

A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia

Affiliations
  • 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.

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.

Keyword

Acquired superior oblique muscle palsy; Trochlear nerve schwannoma; Trochlear nerve tumor

MeSH Terms

Adult
Brain Stem
Diplopia*
Eyeglasses
Follow-Up Studies
Glass
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neurilemmoma*
Neurofibromatoses
Orbit
Paralysis
Telescopes*
Trochlear Nerve*
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error