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Case report: isolated trochlear nerve palsy associated with posterior cerebral artery aneurysm

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Abstract

We describe a case of isolated trochlear nerve palsy caused by an unruptured posterior cerebral artery (PCA) aneurysm in an 82-year-old male who consulted an ophthalmologist after developing diplopia. Magnetic resonance angiography showed a left PCA aneurysm in the ambient cistern, and T2WI showed an aneurysm compressing the left trochlear nerve to the cerebellar tentorium. Digital subtraction angiography revealed that the lesion was located between the left P2a segment. We attributed this isolated trochlear palsy to left PCA unruptured aneurysm pressure. Thus, we performed stent-assisted coil embolization. The aneurysm was obliterated, and trochlear nerve palsy improved completely.

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Abbreviations

DSA:

Digital subtraction angiography

ICA:

Internal cerebral artery

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

PAO:

Parent artery occlusion

PCA:

Posterior cerebral artery

TSE:

Turbo spin echo

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Funding

This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sector.

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Author notes

  1. Taisuke Yoshinaga and Hironori Fukumoto equally contributed to the study.

Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Taisuke Yoshinaga, Hironori Fukumoto & Hiroshi Abe

  2. Department of Neurosurgery, Fukuoka University Hospital, Fukuoka, Japan

    Dai Kawano, Hiromasa Kobayashi & Takashi Morishita

  3. Department of Neurosurgery, Hakujuji Hospital, Fukuoka, Japan

    Kenji Fukuda & Tooru Inoue

Authors
  1. Taisuke Yoshinaga
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  2. Hironori Fukumoto
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  3. Dai Kawano
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  4. Hiromasa Kobayashi
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  5. Kenji Fukuda
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  6. Takashi Morishita
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  7. Tooru Inoue
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  8. Hiroshi Abe
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Contributions

Taisuke Yoshinaga: conceptualization and writing of the original draft. Hironori Fukumoto: conceptualization, supervision, and writing of the original draft. Dai Kawano: writing, review, and editing. Hiromasa Kobayashi: writing, review, and editing. Kenji Fukuda: supervision. Takashi Morishita: supervision and writing of the original draft. Tooru Inoue: supervision. Hiroshi Abe: supervision, writing–review, and editing.

Corresponding author

Correspondence to Hironori Fukumoto.

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Conflicts of interest

The authors declare no conflicts of interest concerning the materials or methods used in this case report, or the findings of this study.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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The patient and his family approved the writing of this paper.

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Yoshinaga, T., Fukumoto, H., Kawano, D. et al. Case report: isolated trochlear nerve palsy associated with posterior cerebral artery aneurysm. Acta Neurochir 165, 1027–1030 (2023). https://doi.org/10.1007/s00701-023-05530-9

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  • DOI: https://doi.org/10.1007/s00701-023-05530-9

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