title: Superior oblique paresis with contralateral relative afferent pupillary defect.
abstract: BACKGROUND
  The purpose of this study is to report a case of superior oblique paresis and contralateral relative afferent pupillary defect (RAPD) with normal vision in a patient with brainstem astrocytoma.
  
  
  METHODS
  We correlated the patient's clinical findings with anatomical substrates on magnetic resonance imaging (MRI) findings.
  
  
  RESULTS
  The patient had right-sided superior oblique paresis. There was a left-sided RAPD, although visual acuities and visual fields were normal in both eyes. T1-weighted, gadolinium-enhanced MRI demonstrated a hyperintense area in the right dorsal midbrain.
  
  
  CONCLUSIONS
  It is suggested that the lesion damaged both the pretectal afferent pupillary pathway and fascicles of the trochlear nerve, causing a unique combination of neuro-ophthalmologic findings.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Taguchi
authors.forename: S
authors.initials: S
authors.lastname: Kashii
authors.forename: M
authors.initials: M
authors.lastname: Kikuchi
authors.forename: H
authors.initials: H
authors.lastname: Yasuyoshi
authors.forename: Y
authors.initials: Y
authors.lastname: Honda
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000150:complications* / Q000175:diagnosis; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology*; D020432:Trochlear Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields