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Trochlear Nerve

María García-Zamora, Hortensia Sánchez-Tocino, Ana Villanueva-Gómez, José Miguel Angles-Deza, Elena Pérez-Gutierrez
Tuberculous meningitis is a type of subacute meningitis and like other intracranial processes can compromise ocular motor nerves, causing palsies. Trochlear nerve is an unusual isolated manifestation in this type of pathology. The authors report a 5-year-old boy presented in their clinic with a trochlear nerve palsy as unique neurological manifestation of tuberculous meningitis. Treatment with complete anti-tuberculous therapy and botulinum A toxin was needed to get the complete resolution of the nerve palsy...
February 2016: Neuro-ophthalmology
Liu Xinrui, Yuichi Sato, Mitsuru Dan, Hiroki Kuroda, Toshihiro Kumabe
BACKGROUND: Approximately 60 cases of schwannoma unrelated to the cranial nerve have been reported, and only 12 arose from the tentorium. We present a case of tentorial schwannoma extending into the pons and midbrain without cranial nerve involvement, which was almost totally resected through an occipital trans-tentorial approach. CASE DESCRIPTION: A 37-year-old man was admitted to our institution with memory disturbance beginning 2 years ago and gait disturbance from one year ago...
November 19, 2016: World Neurosurgery
Seong-Hae Jeong, Sung-Hee Kim, Seung-Han Lee, Seong-Ho Park, Hyo-Jung Kim, Ji-Soo Kim
BACKGROUND: The trochlear (fourth) nerve is the only cranial nerve that decussates before emerging from the posterior aspect of the brainstem. Lesions involving the trochlear nucleus or fascicles mostly give rise to contralesional superior oblique palsy (SOP). METHODS: We report 2 patients with SOP on the side of intraaxial lesions with a literature review on central trochlear palsy. RESULTS: The lesions are more commonly located posterior to the cerebral aqueduct in patients with ipsilesional SOP than in those with contralesional SOP...
December 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Satoshi Matsuo, Serhat Baydin, Abuzer Güngör, Koichi Miki, Noritaka Komune, Ryota Kurogi, Koji Iihara, Albert L Rhoton
OBJECTIVE A common approach to lesions of the pineal region is along the midline below the torcula. However, reports of how shifting the approach off midline affects the surgical exposure and relationships between the tributaries of the vein of Galen are limited. The purpose of this study is to examine the microsurgical and endoscopic anatomy of the pineal region as seen through the supracerebellar infratentorial approaches, including midline, paramedian, lateral, and far-lateral routes. METHODS The quadrigeminal cisterns of 8 formalin-fixed adult cadaveric heads were dissected and examined with the aid of a surgical microscope and straight endoscope...
October 7, 2016: Journal of Neurosurgery
Pengfei Liu, Yuhai Bao, Wenchuan Zhang
Trochlear nerve schwannoma is extremely rare, with only 35 pathologically confirmed patients being reported in the literature. Here, the authors report a patient of trochlear nerve schwannoma in the prepontine cistern manifesting as facial pain and double vision and presenting the image characteristics of repeated intratumoral hemorrhage, which has never been reported in the literature. Total tumor along with a portion of the trochlear nerve was removed by using a retrosigmoid approach. Facial pain disappeared after operation, and the diplopia remained...
September 2016: Journal of Craniofacial Surgery
Veena Sheshadri, Suparna Bharadwaj, B A Chandramouli
BACKGROUND AND AIMS: Intra-operative identification and preservation of extraocular motor nerves is one of the main goals of surgeries for skull base tumours and this is done by monitoring the extraocular movement (EOM). Intra-operative electromyographic monitoring has been reported, but it is a complex and skilful process. Electrooculography (EOG) is a simple and reliable technique for monitoring EOMs. We aimed to assess the utility of EOG monitoring in preventing extraocular motor nerve dysfunction during skull base surgeries...
August 2016: Indian Journal of Anaesthesia
Nurhan Torun, Yosef Laviv, Kianush Karimian Jazi, Anand Mahadevan, Rafeeque A Bhadelia, Anderson Matthew, Mitchell Strominger, Ekkehard M Kasper
Schwannomas of cranial nerves in the absence of systemic neurofibromatosis are relatively rare. Among these, schwannomas of the trochlear nerve are even less common. They can be found incidentally or when they cause diplopia or other significant neurological deficits. Treatment options include observation only, neuro-ophthalmological intervention, and/or neurosurgical management via resection or sterotactic radiosurgery (SRS). In recent years, the latter has become an attractive therapeutic tool for a number of benign skull base neoplasm including a small number of reports on its successful use for trochlear Schwannomas...
September 1, 2016: Neurosurgical Review
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Nauman S Chaudhry, Faiz U Ahmad, Jacques J Morcos
Schwannomas arising from the trochlear nerve are very rare and to our knowledge, less than 35 histologically documented cases have been reported in the literature. There are no reports of a schwannoma in the pineal region. We report a 24-year-old woman who underwent a para-occipital trans-tentorial approach and gross total excision of a pineal region schwannoma arising from the trochlear nerve. This is the first such reported case.
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sherma Tavighi, Zohreh Saadatfar, Bahador Shojaei, Morteza Behnam Rassouli
In this study the cranial nerves development of H. huso are explained from 1 to 54-days-old (1, 3, 6, 15, 21 and 54 days). Despite all the researches on fish brain, there are no study on nerves evolution on H. huso during their larvae life. For this research 40 samples of larvae H. huso were obtained (from each age, about six samples were selected). The specimens were maintained in fiberglass tank, then histological samples were taken from tissues and stained with hematoxylin and eosin for general histological studies using light microscope...
2016: Veterinary Research Forum
Fatma Yulek, Joseph L Demer
BACKGROUND: Progressive strabismus initially considered idiopathic may be caused by isolated schwannomas of motor nerves to extraocular muscles, detectable only on careful imaging. This study reviewed clinical experience of a referral practice in identifying schwannomas on magnetic resonance imaging (MRI). METHODS: We reviewed 647 cases imaged for strabismus to identify presumed cranial nerve schwannomas, identified by gadodiamide-enhanced, high-resolution surface coil orbital MRI and thin-section cranial MRI...
August 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Ji Eun Lee, Hee Kyung Yang, Jeong-Min Hwang
OBJECTIVES: To compare the surgical outcomes of inferior oblique (IO) myectomy in congenital superior oblique palsy (SOP) according to the presence of the trochlear nerve identified with high-resolution MRI. DATA EXTRACTION: Forty-one congenital SOP patients without a trochlear nerve (absent group) and 23 patients with a trochlear nerve (present group) who underwent IO myectomy as the primary surgical treatment were retrospectively reviewed. "Motor success" was defined as postoperative ipsilateral hypertropia ≤ 4 prism diopter (PD)...
2016: PloS One
Michael Strupp, Marianne Dieterich, Thomas Brandt, Katharina Feil
Neurovascular compression syndromes are characterized by recurrent attacks of neurological symptoms and clinical signs depending on the cranial nerve affected. It is assumed that pulsatile compression of the nerve is caused mainly by an artery. The result is segmental demyelination of the transition zone or the central part of the cranial nerve, which is covered by oligodendrocytes, and subsequent ephaptic axonal transmission. Compression of the vestibular nerve can cause attacks of spinning or non-spinning vertigo: vestibular paroxysmia...
July 2016: Current Treatment Options in Neurology
Roberto Colasanti, Al-Rahim Abbasali Tailor, Jun Zhang, Mario Ammirati
OBJECTIVE: Complex skull base approaches are often used to treat lesions within the middle incisural space; yet the well-known retrosigmoid route may provide an effective avenue to this difficult-to-reach region. The purpose of this study was to quantify the exposure advantages on the middle incisural space provided by cutting of the tentorium cerebelli via a standard suboccipital retrosigmoid approach (i.e., via the cerebellopontine cistern route). Also, 2 illustrative cases are presented...
August 2016: World Neurosurgery
Alan Edwards, Evan Larson, Mitchell Beckert, Nikhil Sahai, John P Albright
BACKGROUND: Tibial tubercle-trochlear groove (TT-TG) distance is currently used at our institution to determine tibial tubercle medialization required in Fulkerson osteotomies. If the correlation between a modified lateral patellar edge (LPE) and the transfer distance was found to be stronger than its correlation with TT-TG, it would suggest that the best measurement to use is actually modified LPE. METHODS: The electronic medical records of 32 patients who underwent Fulkerson osteotomy procedures with femoral nerve stimulation were reviewed and measured...
August 2016: Knee
E Emily Bennett, Balint Otvos, Varun R Kshettry, Jorge Gonzalez-Martinez
INTRODUCTION: Haemangioblastoma has been uncommonly reported to occur in coexistence either temporally or spatially with the development of an arteriovenous malformations (AVM). We present a case of a delayed AVM following haemangioblastoma resection. PRESENTATION OF CASE: 44 year old female initially presented with a several week history of headaches, vertigo and nausea and emesis and was found to have a cystic lesion with a solid enhancing component on Magnetic Resonance Imaging (MRI) in the superior aspect of the vermis...
2016: International Journal of Surgery Case Reports
Harith Akram, Sarah Miller, Susie Lagrata, Jonathan Hyam, Marjan Jahanshahi, Marwan Hariz, Manjit Matharu, Ludvic Zrinzo
OBJECTIVE: To present outcomes in a cohort of medically intractable chronic cluster headache (CCH) patients treated with ventral tegmental area (VTA) deep brain stimulation (DBS). METHODS: In an uncontrolled open-label prospective study, 21 patients (17 male; mean age 52 years) with medically refractory CCH were selected for ipsilateral VTA-DBS by a specialist multidisciplinary team including a headache neurologist and functional neurosurgeon. Patients had also failed or were denied access to occipital nerve stimulation within the UK National Health Service...
May 3, 2016: Neurology
Marijn Stuut, Gusta van Zwieten, Jos M Straetmans, Martin Lacko, Constance T R M Stumpel
Anterior neck masses in young children can be a diagnostic challenge for otolaryngologists and radiologists. We present a rare case of herniation of normal mediastinal thymus in a four-year-old girl. Additional medical features as an inguinal hernia and trochlear nerve paresis raised the question whether there is a causal relationship or an association. A connective tissue disorder could not be diagnosed as possible causal factor to the abnormal movement of the mediastinal thymus. Awareness and recognition of this benign phenomenon is important in order to avoid unnecessary biopsy or surgery...
April 2016: International Journal of Pediatric Otorhinolaryngology
D C Bowe, E A Gruber, N M H McLeod
The head and neck is anatomically complex, and several nerves are at risk during orthognathic operations. Some injuries to nerves are reported more commonly than others. To find out what consultant surgeons tell their patients about the prevalence of common nerve injuries before orthognathic operations, we did a postal survey of fellows of the British Association of Oral and Maxillofacial Surgeons (BAOMS). We also reviewed published papers to find out the reported incidence of injuries to cranial motor nerves during orthognathic operations...
May 2016: British Journal of Oral & Maxillofacial Surgery
María Luz Cuadrado, Angel L Guerrero, Juan A Pareja
Epicrania fugax (EF) is a primary headache of recent description. EF essentially consists of brief paroxysms of pain describing a linear or zigzag trajectory across the surface of one hemicranium, commencing and terminating in the territories of different nerves. The pain of forward EF originates in a particular area of the occipital, parietal or temporal regions and moves anteriorly, whereas the pain of backward EF originates in the frontal area, the eye or the nose and moves posteriorly. Some patients have ocular or nasal autonomic accompaniments, and some have triggers...
April 2016: Current Pain and Headache Reports
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