Synchronous ipsilateral cavernous malformations of the trochlear nerve
| Autor: | Christopher S. Graffeo, William R. Copeland, Perkins Mukunyadzi, Ali F. Krisht |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Physical examination Trochlear Nerve Schwannoma Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Physiology (medical) Hemangioblastoma medicine Paralysis Humans Cranial Nerve Neoplasms Diplopia medicine.diagnostic_test business.industry Trochlear nerve General Medicine Anatomy Middle Aged medicine.disease Cavernous malformations Magnetic Resonance Imaging eye diseases Trochlear Nerve Diseases Neurology 030220 oncology & carcinogenesis Surgery Neurology (clinical) Radiology medicine.symptom Differential diagnosis business 030217 neurology & neurosurgery Neurilemmoma |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 40 |
| ISSN: | 1532-2653 |
| Popis: | Background Cranial nerve cavernous malformations (CM) are rare benign congenital vascular anomalies, with approximately 44 preceding cases in the literature. We report the fifth case of trochlear CM, as well as the first instance of two discrete CM occurring simultaneously along the same cranial nerve. Methods Case report. Results A fifty-seven year-old man presented with several years of diplopia; physical examination identified a complete left trochlear nerve paralysis. MRI revealed a 1 cm enhancing lesion within the left ambient cistern, and the patient underwent left pretemporal transcavernous resection. Intraoperatively, a second, discrete CM of the trochlear nerve was also discovered; wide excision of the intrinsic trochlear lesions was completed, allowing both tumors to be removed en bloc with negative margins. Pathologic analysis confirmed both to be CM of the trochlear nerve. The patient recovered with a persistent left trochlear paralysis only, and follow-up MRI was negative for residual or recurrent disease. Conclusion Cranial nerve CM are rare but potentially morbid mass lesions, with the capacity to precipitate significant neuropathies. Differential diagnosis includes schwannoma and hemangioblastoma. Definitive diagnosis may not be possible preoperatively; however, resection is recommended in symptomatic patients, potentially accompanied by nerve repair. |
| Databáze: | OpenAIRE |
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