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KMID : 1001920100470050392
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Journal of Korean Neurosurgical Society
2010 Volume.47 No. 5 p.392 ~ p.394
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Isolated, Contralateral Trochlear Nerve Palsy Associated with a Ruptured Right Posterior Communicating Artery Aneurysm
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Son Seong
Park Cheol-Wan
Yoo Chan-Jong
Kim Eun-Young
Kim Jae-Myoung
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Abstract
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Trochlear nerve palsy associated with spontaneous subarachnoid hemorrhage (SAH) is known to be a rare malady. We report here on a patient who suffered with left trochlear nerve palsy following rupture of a right posterior communicating artery aneurysm. A 56-year-woman visited our emergency department with stuporous mental change. Her Hunt-and-Hess grade was 3 and the Fisher grade was 4. Cerebral angiography revealed a ruptured aneurysm of the right posterior communicating artery. The aneurysm was clipped via a right pterional approach on the day of admission. The patient complained of diplopia when she gazed to the left side, and the ophthalmologist found limited left inferolateral side gazing due to left superior oblique muscle palsy on day 3. Elevated intracranial pressure, intraventricular hemorrhage or a dense clot in the basal cisterns might have caused this trochlear nerve palsy.
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KEYWORD
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Posterior communicating artery aneurysm, Trochlear nerve paresis, Subarachnoid hemorrhage
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