Presentation
Clinical picture of right 4th cranial nerve palsy for 1.5 years.
Patient Data
Small area (1x1x1 cm) of abnormal signal in the posterior aspect of the left side of mid brain inferior to the tectum. It returns a high signal on T2, a faint signal on FLAIR, no post-contrast enhancement, no diffusion restriction, no T2 *GRE blooming artifact, and no significant surrounding edema.
Case Discussion
The MRI features suggest old inflammatory/ischemic insult in the posterior aspect of the midbrain where the fourth cranial nerve arises. Unfortunately no further clinical or laboratory data or post treatment follow up available for definite diagnosis.
The trochlear nerve or fourth cranial nerve (CN IV) and one of the ocular motor nerves. It originates in the midbrain and is exiting from the dorsal part of the brainstem.
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