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4th nerve palsy
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4th nerve palsy

I am a 41yo female with a symptomatic pineal cyst that is causing double vision.  I have gone to two neuro-ophthalmologists who both disgnosed me with dorsal midbrain syndrome.  I have always had this cyst and the size has not changed that much over the years except for increased calcification.  In addition I have seen two neurologists, and two neurosurgeons who agree that this cyst needs to be removed/fenestrated.  There is also a VI or pseudo VI nerve palsy in addition to the partial IV.  I am scheduled for supracerebellar/infratentorial sitting craniotomy.  The cyst is the only thing showing up on my MRI.  Could something else be causing my double vision?  I have not had any trauma but my vision also just goes blurry.  What other things might cause this vision problem?  Are there any other tests that I should have done? Could this be vascular in origin?  or would that show up on the MRI?
thanks
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In general, a pineal tumor can cranial nerve deficits.  However, they are the only cause of cranial nerve deficits.  I do not have your records or films to review, however getting multiple opinions is a good thing to do to understand your condition.  If you are still concerned after getting a 2nd opinion, it is reasonable to get another opinion.  Sometimes, getting another consultation will help you better understand your condition and allow you feel more involved in your decision.
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