Content area
Full Text
Dr. Jamieson reports no financial relationships relevant to this field of study.
Source: Smith JH, et al. Clinical features and long-term prognosis of trochlear headaches. Eur J Neurol 2014;21:577-585.
The trochlear nerve (cranial nerve iv) innervates a single muscle: the superior oblique muscle that depresses and adducts the eye. The tendon of the trochlear nerve sits in the trochlea, a saddle or pulley-like cartilaginous structure that is located in the superomedial orbit. Inflammation of the trochlea, trochleitis, produces swelling and tenderness, presenting as a unilateral periorbital pain, a headache referable to the trochlear apparatus. Trochleitis can be idiopathic or secondary to inflammatory or autoimmune connective tissue disorders. A primary trochlear headache, not associated with inflammation, has also been described. Smith et al described 25 cases of this rare trochlear headache disorder, compiled retrospectively over 5 years (2007-2012) after diagnosis at the Mayo Clinic. The diagnosis of trochlear headache was not recognized by the referring neurologist or...