2009•Indian Journal of OphthalmologyOpen access

Isolated trochlear nerve palsy with midbrain hemorrhage

Surabhi Sai P. Raghavendra, K Vasudha, SRavi Shankar

Abstract

Midbrain hemorrhage causing isolated fourth nerve palsy is extremely rare. Idiopathic, traumatic and congenital abnormalities are the most common causes of fourth nerve palsy. We report acute isolated fourth nerve palsy in an 18-year-old lady due to a midbrain hemorrhage probably due to a midbrain cavernoma. The case highlights the need for neuroimaging in selected cases of isolated trochlear nerve palsy.

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Key concepts: Midbrain, Trochlear nerve, Palsy, Medicine, Oculomotor nerve palsy, Neuroimaging, Anatomy, Anesthesia