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KMID : 0360220160570111812
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Journal of the Korean Ophthalmological Society
2016 Volume.57 No. 11 p.1812 ~ p.1816
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A Case of Trochlear Nerve Schwannoma Presenting with Binocular Diplopia
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Kee Hyun-Ju
Yoo Hyun-Ju
Kim Jae-Hyoung
Yang Hee-Kyung
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Abstract
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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.
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KEYWORD
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Acquired superior oblique muscle palsy, Trochlear nerve schwannoma, Trochlear nerve tumor
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