Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.
Rashad Jabarkheel, Samuel Tomlinson, Austin J Borja, Sonia Ajmera, Stephen P Miranda, John Y K Lee
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Abstract
Background and importance: We describe, to our knowledge, the first report of fully endoscopic microvascular decompression (MVD) of the trochlear nerve in a patient with superior oblique myokymia (SOM).
Clinical presentation: A 51-year-old female presented with multiple years of intermittent, "jumpy," and "shimmering" visual disturbances. She was diagnosed with SOM. Magnetic resonance imaging showed right trochlear nerve compression within the perimesencephalic cistern between the free edge of the right tentorial leaflet and the right superior cerebellar artery. She underwent fully endoscopic MVD of the trochlear nerve with complete resolution of symptoms.
Conclusion: Endoscopic MVD of the trochlear nerve is technically feasible and may be used to treat medically refractory SOM.
期刊介绍:
Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique