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Localization of post-traumatic trochlear nerve palsy associated with hemorrhage at the subarachnoid space by magnetic
1Ophthalmologic Service, Higashiyamato Hospital, 1-13-12 Nangai, Higashiyamato, Tokyo, 207-0014 Japan. naotoh@gw1.gateway.ne.jp
Purpose:
To report evaluation of traumatic trochlear nerve palsy using head magnetic resonance imaging.
Design:
Observational case reports.
Methods:
We examined two cases involving trochlear nerve palsy after closed head injury.
Results:
Using a fluid attenuated inversion recovery pulse sequence, MRI showed a high-intensity lesion consistent with subarachnoid hemorrhage at the trochlear nerve area in the ambient cisterns.
Conclusion:
An impact force directed toward the tentorium can be a mechanism of injury in some post-traumatic trochlear nerve palsies. Fluid attenuated inversion recovery pulse sequence is a sensitive method for detection of abnormalities in cases associated with head injury.
Insights
Traumatic trochlear nerve palsy after head injury can be diagnosed using head magnetic resonance imaging (MRI). A specific MRI sequence detected subarachnoid hemorrhage, indicating a potential injury mechanism.
Area of Science:
- Neuroimaging
- Neurology
- Traumatology
Background:
- Traumatic trochlear nerve palsy is a rare condition.
- Diagnosis often relies on clinical presentation and imaging.
- Understanding injury mechanisms is crucial for patient management.
Observation:
- Two cases of trochlear nerve palsy following closed head injury were evaluated.
- Magnetic resonance imaging (MRI) was utilized for assessment.
- A specific MRI sequence, fluid-attenuated inversion recovery (FLAIR), was employed.
Findings:
- MRI revealed high-intensity lesions in the trochlear nerve area within the ambient cisterns.
- These lesions were consistent with subarachnoid hemorrhage.
- FLAIR sequence demonstrated high sensitivity in detecting these abnormalities.
Implications:
- Impact force directed toward the tentorium may cause trochlear nerve palsy.
- FLAIR MRI is a valuable tool for detecting abnormalities in traumatic brain injury.
- This imaging technique aids in understanding the pathophysiology of post-traumatic cranial nerve palsies.