фильм люцифер 1 Ñезон 2016 Ñмотреть онлайн беÑплатно
Главное меню:
ИнтереÑное
фильм люцифер 1 Ñезон 2016 Ñмотреть онлайн беÑплатно, Fourth (Trochlear) Nerve Schwannoma - University of Iowa, Atlas Entry - Cranial Nerve IV (Trochlear Nerve) Palsy, Cranial Nerve IV (Trochlear Nerve) Palsy - University of Iowa, Atlas Entry - Bilateral 4th Nerve Palsy - University of Iowa, EyeRounds.org: Acute Onset of Unilateral Trochleitis, Vertical Oscillopsia: A Case of Superior Oblique Myokymia, Atlas Entry - Cavernous Sinus Syndrome - University of Iowa.
This patient presented after closed head trauma with a complaint of predominantly vertical, binocular diplopia ever since the event. The diplopia was worse with left gaze and improved with left head tilt. He adopted a mild left head tilt and had a right hypertropia in primary gaze. The right hypertropia worsened with left gaze and right head tilt (not pictured). There is underaction of the right superior oblique and overaction of the right inferior oblique that are best appreciated with the right eye in adduction looking in the vertical directions. There was 10 degrees of excyclotorsion on double Maddox rod testing. MRI scan was normal. This presentation was consistent with a traumatic right cranial nerve IV palsy., Fourth nerve axons pass dorsally and then decussate within the superior medullary velum to emerge from the contralateral dorsal surface of the brainstem. The subarachnoid portion of the nerve passes ventrally through the ambient and peri-mesencephalic cisterns before passing between the posterior cerebral and superior cerebellar arteries., Cranial nerve IV (trochlear nerve) innervates the superior oblique muscle which is responsible for depression and intorsion of the eye..
Cranial nerve IV (trochlear nerve) is a somatic motor nerve that innervates the superior oblique muscle, which intorts, infraducts, and abducts the globe. The nucleus of CN IV lies at the level of the inferior colliculus in the tegmentum of the midbrain., This patient highlights all of the typical features of bilateral 4th nerve palsies, including a V-pattern esotropia, reversing hypertropia on left and right gaze (also with left and right head tilt - not shown), underaction of the superior oblique in depression while adducting, and overaction of the inferior oblique in elevation while adducting. There was also 15 degrees of excyclotorsion , The most widely accepted etiology of trochlear pain is inflammatory. First documented in 1984, biopsy of the superior oblique muscle in a patient with trochlear pain showed perivascular lymphocytic invasion of the myofibrils [15]., Mikami T, Minamida Y, Ohtsuka K, Houkin K. Resolution of superior oblique myokymia following microvascular decompression of trochlear nerve. Acta Neurochir (Wien) 2005;147 (9):1005-1006., The clinical presentation typically consists of various combinations of ocular motor nerve impairments (Oculomotor Nerve - CN III, Trochlear Nerve - CN IV, and Abducens Nerve - CN VI), Horner syndrome, and sensory loss of the first (V1) or second (V2) division of the trigeminal nerve (CN V). There are a variety of etiologies that can cause this., Heather A. Stiff, MD Dr. Heather Stiff is an ophthalmologist at Children's Hospital and Medical College of Wisconsin in Milwaukee, WI. Dr. Stiff completed her Ophthalmology Residency at the University of Iowa Department of Ophthalmology and Visual Sciences in June 2020, continuing on to complete a Pediatric Ophthalmology and Strabismus Fellowship at the University of Iowa Department of .