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[Trochlear neurinoma: case report].

M Yamamoto, M Jimbo, E Takara

    No Shinkei Geka. Neurological Surgery
    |March 1, 1984
    PubMed
    Summary
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    A rare case of solitary neurinoma affecting the trochlear nerve is presented. This tumor caused double vision (diplopia) due to superior oblique muscle palsy, successfully removed via craniotomy.

    Area of Science:

    • Neuro-oncology
    • Ophthalmology
    • Neurosurgery

    Background:

    • Solitary neurinomas are rare tumors arising from nerve sheath cells.
    • Trochlear nerve (cranial nerve IV) involvement can lead to characteristic visual disturbances.
    • Diplopia and headache are potential presenting symptoms.

    Observation:

    • A 37-year-old female presented with sudden onset headache, nausea, vomiting, and subsequent diplopia.
    • Ophthalmological examination confirmed right superior oblique muscle palsy.
    • CT scan revealed a solitary enhancing mass near the right tentorial incisura.

    Findings:

    • Extensive work-up, including angiography and lumbar puncture, yielded no other abnormalities.
    • Surgical resection via a subtemporal-transtentorial approach successfully removed the tumor.

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  • Histological analysis confirmed the tumor as a neurinoma of Antoni A type, involving the trochlear nerve.

    • Implications:

    • This case highlights the importance of considering neurinomas in the differential diagnosis of isolated cranial nerve palsies.
    • Surgical management can be effective for localized neurinomas, though functional deficits may persist.
    • Accurate diagnosis and surgical planning are crucial for managing these rare intracranial tumors.