Oculomotor nerve schwannoma

Oculomotor nerve schwannoma is an extremely rare tumour. Only 26 sufficiently described cases of oculomotor nerve schwannomas were found in the literature. The case of an oculomotor nerve schwannoma in a 12-year-old girl is presented. Clinical manifestations, as well as the aim for the radical resection with oculomotor function preservation are reviewed.     

En bloc resection of an intracavernous oculomotor nerve schwannoma and grafting of the oculomotor nerve with sural nerve. Case report and review of the literature

A case in which a left oculomotor nerve schwannoma treated by en bloc resection of the lesion and grafting of the oculomotor nerve with sural nerve is presented. Recovery of nerve function was partial, but useful and cosmetically good. The last follow-up examination performed 2 years after surgery revealed recovery of function in the elevator muscle of the upper eyelid, together with slight vertical movement of the eye.     

Facial nerve schwannoma in the cerebellopontine cistern. Findings on high resolution CT and MR cisternography

We report a case of facial nerve schwannoma originating in the cerebellopontine cistern, diagnosed by cochlear sensorineural hearing loss, and involvement in the facial nerve canal and the anterior epitympanic recess. Precise analyses of neuro-otological and neuroradiological studies are crucial to obtain an accurate preoperative diagnosis.     

Neurinoma of the oculomotor nerve

A case of intracranial neurinoma with discrete oculomotor nerve palsy and ipsilateral exophthalmos was reported. Review of the literature revealed that oculomotor palsy as the initial symptom may be pathognomonic in the neurinoma originating from the oculomotor nerve.     

Schwannoma of the oculomotor nerve

A case is described of oculomotor nerve sheath tumour presenting with signs and symptoms of a posterior fossa space occupying lesion with minimal involvement of the IIIrd nerve.     

Sciatic nerve schwannoma

Schwannomas are benign tumors of the nerve sheath, commonly seen in the vestibular nerve. Although they are common in the head and neck areas, their occurrence in extra-cranial locations is rare. We report a case of a sciatic nerve schwannoma and review the literature.     

Oculomotor nerve repair using interposed nerve graft.

A case of interposed nerve graft repair of an oculomotor nerve damaged during surgery for a laterally growing retrosellar pituitary adenoma is reported. The patient showed partial but functionally useful recovery of nerve function and was able to resume professional work. Only a few reports of end-to-end repair have been published, and they indicate that partial return of nerve function can be expected in such cases.     

Sporadic malignant nerve sheath tumour of the oculomotor nerve

Malignant peripheral nerve sheath tumours (MPNST) are exceedingly rare in an intracranial location. In this report clinical and pathological evidence for the diagnosis of a MPNST arising from of the oclumotor nerve is presented. To our knowledge this is the first such case reported in the medical literature.     

Histopathologic changes in oculomotor nerve and ciliary ganglion in aneurysmatic compression injuries of oculomotor nerve.

BACKGROUND: Bilateral common carotid artery ligation (BCCAL) increases vertebrobasilar blood flow and leads to increased luminal pressure, luminal enlargement, wall thinning, convolutions and sometimes aneurysm formation in posterior circulation arteries, especially the posterior communicating arteries (PcomA). PcomA aneurysms compress the oculomotor nerves. The principal aim of this investigation is to examine the histopathologic results of the compressive effect of PcomA aneurysms on the oculomotor nerves (OMN) and on ciliary ganglions (CG). METHODS: When we observed the effects of BCCAL on the posterior circulation arteries of the brain in fifteen ligated rabbits after sacrifice, we noticed aneurysm formation on these arteries in three rabbits. These aneurysms developed on the PcomAs compressed the oculomotor nerves. These compressed nerves and normal oculomotor nerves together with their ciliary ganglions were examined histopathologically. RESULTS: A PComA aneurysm developed in three rabbits from 15 ligated animals and these aneurysms compressed the oculomotor nerves on the same side. Partial peripheral necrosis and axonal loss were seen on the compressed oculomotor nerves. Concomitantly, cellular loss and necrosis were also observed on their ganglions. CONCLUSION: Bilateral common carotid artery ligation may lead to PcomAs and these aneurysms could compress the oculomotor nerves. Compression injuries of oculomotor nerve may cause cellular injury and necrosis on both oculomotor nerves and ciliary ganglions.     

Malignant schwannoma in the posterior tibial nerve

Our group have studied a patient affected by a malignant schwannoma in the posterior tibial nerve. Schwannomas are uncommon neoplasms that originate from the Schwann cells of the peripheral nerves: the most common forms are benign. Malignant transformation is rarer. The therapy is surgical and the operation undertaken, if possible, should be the amputation. Alternatively, where amputation is not possible due to the specific localisation or due to patient refusal, the alternative must be the largest and most radical excision possible.     

Cervical vagus nerve schwannoma

Schwannomas arising from cervical cranial nerves rarely present as neck swelling. Ultrasonography, computerised tomography, magnetic resonance imaging and fine needle aspiration cytology are helpful in reaching a diagnosis. Surgical excision is the treatment of choice. A case of large cervical vagus nerve schwannoma occurring in a young lady is presented with its management.     

Oculomotor nerve palsy in patients with cerebral aneurysms

Twenty-six patients with oculomotor nerve palsy due to cerebral aneurysms were examined. There were six males and twenty females with a mean age of 55 years. 25 of the 26 aneurysms were located at the junction of the internal carotid and the posterior communicating artery and one was at the junction of the basilar artery and the superior cerebellar artery. Twelve patients had associated subarachnoid hemorrhage (SAH); the other 14 did not. The initial symptoms in many patients were ptosis and double vision. Twenty-one of the patients had total oculomotor nerve palsy, one had a sparing of medial rectus muscle; three patients had only ptosis and anisocoria, and one had oculomotor nerve palsy with pupillary sparing. All aneurysms, including giant aneurysms, were clipped under a microscope, and six oculomotor nerves were found to be decompressed at surgery. The follow-up periods were from six months to three years. Nine patients had a complete recovery of oculomotor function; thirteen had an incomplete recovery; and four remained unchanged. The mean interval between the onset of palsy and the time of surgery was 24 days in complete recovery cases, 42 days in incomplete recovery cases, and 119 days in unchanged cases. The recovery of oculomotor function started with the levator palpebrae muscle and followed by the medial rectus muscle. The recovery of pupillary function was, however, not consistent. Of the factors influencing recovery from oculomotor nerve palsy, the interval between the onset of palsy and the time of surgery was most important. Therefore, aneurysms with oculomotor nerve palsy should be operated on as early as possible, regardless of the presence or absence of SAH.     

Plexiform schwannoma of the ulnar nerve

Plexiform schwannoma is a rare benign neurogenic tumour; we report a case that arose in the ulnar nerve of a 59-year-old woman. Exploration showed a continuous multinodular tumour that involved the ulnar nerve from the hand to the upper arm; the length of the tumour was 35 cm.     

Intraspinal schwannoma of the accessory nerve

The second example of a schwannoma originating from the cervical portion of the accessory nerve is reported. The tumour was diagnosed by MRI and confirmed by surgery. The tumour was small and was located entirely within the cervical subarachnoid space without causing any detectable neurological deficit.