뇌조조영술 후 발생한 양측 활차신경마비 1예

• 영문명: A Case of Bilateral Trochlear Nerve Palsy Following Cisternography
• 발행기관: 대한안과학회
• 저자명: 김근해 윤숙현 김숙영,Keun Hae Kim, MD, PhD, Sook Hyun Yoon, MD, Sook Young Kim, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume55,number1, 155~160쪽, 전체 6쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2014.01.15

영문 초록

Purpose: To report a case of bilateral trochlear nerve palsy following cisternography. Case summary: A 43-year-old male with intermittent watery rhinorrhea persisting for 3 months visited the neurosurgery department of our institute. His past medical history included removal of a pituitary adenoma 22 years prior to presentation. Cerebrospinal fluid leakage was suspected and cisternography was performed. The patient was referred to our ophthalmology department for diplopia 3 days after the cisternography. An alternate prism cover test showed 5 prism diopter (PD) right hypertrophia in the primary position, and underaction of bilateral superior oblique muscles and overaction of the left inferior oblique muscle. A positive Bielschowsky test with the head tilted to either side was observed and excyclotorsion was 9° on the double Maddox rod test. The patient was diagnosed with bilateral trochlear nerve palsy. After 2 years of follow- up, diplopia persisted and recession of the bilateral inferior oblique muscles was performed. After the surgery, diplopia disappeared, the fundus photography showed no excyclotorsion, and the double Maddox rod test indicated 3° of excyclotorsion. Conclusions: Cisternography should be carefully performed due to the possibility of bilateral trochlear nerve palsy, an extremely rare but possible occurrence following the procedure. J Korean Ophthalmol Soc 2014;55(1):155-160

키워드

Cisternography, Lumbar puncture, Trochlear nerve palsy