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Cavernoma of the trochlear nerve.

Oguzkan Sürücü¹, Ulrich Sure, Michel Mittelbronn

¹Department of Neurosurgery, University of Marburg, Germany. Sueruecu@med.uni-marburg.de

Clinical Neurology and Neurosurgery

|August 3, 2007

Summary

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A rare trochlear nerve cavernoma caused double vision in a 53-year-old man. Surgical removal and nerve repair successfully resolved symptoms and showed no recurrence, marking a first in medical literature.

Area of Science:

Neuroscience
Neurosurgery
Vascular Neurology

Background:

Cerebral cavernous malformations (CCMs) are vascular malformations typically presenting with seizures or focal deficits post-hemorrhage.
CCMs rarely originate from cranial nerves, posing diagnostic and therapeutic challenges.

Observation:

A 53-year-old male presented with progressive double vision attributed to isolated left trochlear nerve palsy.
Cranial magnetic resonance imaging (MRI) identified a small, stable tumor in the left quadrigeminal cistern.

Findings:

Exploratory surgery revealed a cavernoma originating from the left trochlear nerve.
Microsurgical excision of the cavernoma followed by end-to-end anastomosis of the trochlear nerve was performed.

Implications:

Related Experiment Videos

This case represents the first reported instance of a symptomatic cavernous malformation arising from the trochlear nerve.
Successful surgical management of trochlear nerve cavernoma led to complete resolution of diplopia and no tumor recurrence at one-year follow-up.