Open AccessIsolated trochlear palsy as the only presentation of midbrain infarction: a case report
Author(s) -
Wen-Ching Chen,
Ying-Sheng Li,
Poyin Huang
Publication year - 2021
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/03000605211008292
Subject(s) - medicine , palsy , trochlear nerve , magnetic resonance imaging , presentation (obstetrics) , infarction , midbrain , progressive supranuclear palsy , stroke (engine) , pediatrics , surgery , radiology , pathology , central nervous system , myocardial infarction , mechanical engineering , alternative medicine , engineering , atrophy
Trochlear palsy often results from traumatic, congenital and microvascular disorders. An intra-axial lesion as a cause of trochlear palsy is uncommon. Moreover, it usually accompanies other neurological deficits. Isolated trochlear palsy as the only presentation of brainstem stroke is unexpected. This current case report describes a 74-year-old male that presented with trochlear palsy without other neurological signs. Brain magnetic resonance imaging (MRI) revealed an acute midbrain infarction. The case report also reviews recent literature and provides a stepwise algorithm for clinicians to approach patients with trochlear palsy. Despite its rarity, clinicians are advised to consider ischaemic stroke as a cause of trochlear palsy even without other neurological deficits. Early MRI should be performed for prompt and proper management.