Spheno–cavernous schwannoma: a case report

Manuel Gadea Nieto, Eva Moreno Medina, Ricardo Murillo Alvarez, Fernando Alvarado Acosta

Abstract

INTRODUCTION: Schwannomas of the central nervous system usually originate from the vestibular nerve and occasionally from the trigeminal nerve. Those that originate within the cavernous sinus are extremely rare and the literature is scanty.

CASE REPORT: We present the report of the first case managed at our neurosurgery service of Hospital México (Costa Rica). We review the pertinent anatomy, and also the pre and post–operatory images.

CONCLUSIONS: Spheno–cavernous sinus schwannomas are rare and should surgically approach by trained surgeons with a great knowledge of microsurgical anatomy and skull base surgery and also with the availability of a microsurgical lab.

Keywords

Cavernous sinus schwannoma; Neurosurgery; Internal carotid plexus; Ocular motility disorders

References

Al–Mefty O, Ayoubi S, Gaber E. Trigeminal schwannomas: Removal of dumbbell–shaped tumors through the expanded Meckel’s cave and outcomes of cranial nerve function. J Neurosurg. 2002;96:453–63.

Celli P, Ferrante L, Acqui M, Mastronardi L, Fortuna A, Palma L. Neurinoma of the third, fourth, and sixth cranial nerves: A survey and report of a new fourth nerve case. Surg Neurol. 1992;38:216–24.

Cusimano MD, Sekhar LN, Sen CN, Pomonis S, Wright DC, Biglan AW, et al. The results of surgery for benign tumors of the cavernous sinus. Neurosurgery. 1995;37:1–10.

Day JD, Fukushima T. The surgical management of trigeminal neuromas. Neurosurgery 1998;42:233–41.

Dolenc VV. Anatomy and Surgery of the Cavernous Sinus. New York: Springer; 1989.

Johnston JA, Parkinson D. Intracranial sympathetic pathways associated with the sixth cranial nerve. J Neurosurg. 1974;40:236–43.

Kinouchi H, Mikawa S, Suzuki A, Sasajima T, Tomura N, Mizoi K. Extradural neuromas at the petrous apex: Report of two cases. Neurosurgery. 2001;49:999–1004.

Ishikawa H. The Ishikawa Classification of Cavernous Sinus Lesions by Clinico–anatomical Findings. Jpn J Ophthalmol. 2001;45:420–4.

Srinivas D, Somanna S, Bangalore A. Ch, Bhagavatula I. Multicompartamental Trigeminal Schwannomas: Management Strategies and Outcome. Skull Base. 2011;21:351–8.

Chul Chung J, Young Chung S, Min Kim S, Sun Park M. Surgery for a case of Three–Compartment Trigeminal Schwannoma: Technical Aspects: J Korean Neurosurg Soc. 2010;48:383–7.

Xian J, Zhang ZZ, Jing Li W, Yang Qinghua Yang B, Qinglin Ch, He Liyan Ch: Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit. Eur Radiol. 2010;20:2221–8.

Zhou J–Y, Lu J–H, Zhen X–Y, Wang W, Xu J–F, Hu W–W. Microsurgical anatomical study of the frontotemporal–zygomatic arch approach to the superior petroclival region. Exp Ther Med. 2011;2:1211–4.

Mastronardi L, Sameshima T, Ducati A, De Waele LF, Ferrante L, Fukushima T. Extradural Middle Fossa Approach. Proposal of a Learning Method: The “Rule of Two Fans”. Technical Note. Skull Base. 2006;16:181–4.

Campero A, Campero AA, Socolovsky M, Martins C, Yasuda A, Basso A, et al. The transzygomatic approach. J Clin Neurosci. 2010;17(11):1428-33.



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