Trochlear nerve schwannomas occurring in patients without neurofibromatosis: case report and review of the literature

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dc.contributor.authorSantoreneos, Stephenen
dc.contributor.authorHanieh, Ahmaden
dc.contributor.authorJorgensen, Ruth E.en
dc.date.issued1997en
dc.description.abstractOBJECTIVE AND IMPORTANCE: Despite their predilection for sensory nerves, intracranial schwannomas have been reported in a number of mixed and purely motor cranial nerves, especially in association with Type 2 neurofibromatosis. We report the rare occurrence of a trochlear nerve schwannoma in a patient without neurofibromatosis and review 17 other case reports from the literature. CLINICAL PRESENTATION: A 35-year-old woman presented with an 8-week history of evolving left hemiparesis, bilateral bulbar paresis, and out-of-character emotional lability. INTERVENTION: She underwent a left temporal craniotomy and a subtemporal, transtentorial approach to the tentorial hiatus, with complete excision of a cisternal trochlear nerve schwannoma. CONCLUSION: Postoperative complications included temporary oculomotor and abducens nerve palsies and temporary right hemiparesis and mild expressive dysphasia, which were resolved at 23-month follow-up. Pre-operative symptoms and signs completely resolved, but a postoperative complete trochlear nerve palsy required inferior oblique myectomy for correction of diplopia. A review of the literature showed no preoperative trochlear nerve involvement in at least 45% of cases. The tumor is isointense on T1- and T2-weighted magnetic resonance images and enhances brightly with gadolinium. The most frequently used approach for surgical excision is the subtemporal approach, and the tumor is almost always totally excised. Long-term follow-up suggests recovery of preoperative deficit, and persisting or new trochlear nerve palsy is the rule.en
dc.description.statementofresponsibilityStephen Santoreneos, Ahmed Hanieh and Ruth E. Jorgensenen
dc.identifier.citationNeurosurgery, 1997; 41(1):282-287en
dc.identifier.issn0148-396Xen
dc.identifier.urihttp://hdl.handle.net/2440/10218
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkinsen
dc.rightsCopyright © 1997 by the Congress of Neurological Surgeonsen
dc.source.urihttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006123-199707000-00050&LSLINK=80&D=ovften
dc.subjectNerve sheath tumor; Neuroma; Schwannoma; Trochlear nerve neuroma; Trochlear nerve schwannomaen
dc.titleTrochlear nerve schwannomas occurring in patients without neurofibromatosis: case report and review of the literatureen
dc.typeJournal articleen

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