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Images in Neurology
July 2010

Isolated Trochlear Infarction: An Uncommon Cause of Acquired Diplopia

Author Affiliations

Author Affiliations: Departments of Neurology (Drs Walsh, Murphy, and McCabe) and Cardiology (Dr Moore), The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, Trinity College Dublin, Ireland; and Department of Clinical Neurosciences, Royal Free Campus, University College London Institute of Neurology, London, England (Dr McCabe).

Arch Neurol. 2010;67(7):892-893. doi:10.1001/archneurol.2010.131

A 45-year-old woman developed acute diplopia on looking down or to the right. She had a history of migraine with aura, prior Hodgkin lymphoma treated with thoracic irradiation 26 years earlier, epilepsy, smoking, hypertension, hyperlipidemia, and a left middle cerebral artery territory transient ischemic attack 5 years earlier. She previously had surgery, chemotherapy, and radiotherapy for recurrent breast carcinoma. She was taking 200 mg of carbamazepine slow-release formulation daily, 150 mg of aspirin daily, 10 mg of amlodipine daily, 2.5 mg of bendrofluazide daily, 20 mg of tamoxifen daily, and 50 μg of thyroxine daily.