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.     

Neurinoma of the oculomotor nerve. Apropos of a case

A case of a surgically verified neurinoma of the oculomotor nerve is presented. The diagnostic difficulties due to the parasellar localisation are discussed. Computed tomography scan data rarely allow to distinguish the nature of the tumor and in all cases are insufficient to distinguish a trigeminal nerve neurinoma of the oculomotor nerves.     

Neurinoma of the oculomotor nerve--case report.

Only 10 cases of oculomotor nerve neurinoma have been reported previously. The authors report the rarity of a neurinoma originating from Schwann cells of the oculomotor nerve. The diagnosis was based on the initial sign of oculomotor nerve paresis without involvement of other cranial nerves, neuroradiological and surgical findings, and histological features of the specimen obtained at surgery.     

Midbrain hemorrhage presenting with oculomotor nerve palsy: case report

BACKGROUND

We report a case of isolated oculomotor nerve palsy caused by a midbrain hemorrhage.

CASE DESCRIPTION

A 75-year-old man visited our hospital complaining of double vision and left eye ptosis without headache. Neuro-ophthalmic examination showed that his left and right pupils were 3.5 mm and 3 mm in diameter, respectively, that left downward eye movement was limited, and that convergence of the right eye was limited. Magnetic resonance imaging (MRI) demonstrated that there was a hematoma located in the anterior tegmentum of the left midbrain. Two weeks after admission and treatment, including conservative therapy, his double vision gradually disappeared.

CONCLUSION

To date, 73 cases have been reported in the literature. Most cases of isolated oculomotor nerve palsy have been caused by diabetes mellitus, aneurysm, or infarction. However, focal midbrain hemorrhage incidentally produces third nerve palsy. MRI is extremely helpful in diagnosing a small hemorrhage of the midbrain in such cases.     

Neurinoma of the hypoglossal nerve in the submandibular space: case report and review of the literature

Summary Neurinomas of the hypoglossal nerve extending extra-cranially are rare; a schwannoma in a 63-year-old woman causing nerve palsy is reported. The tumour presented as a slow-growing mass in the right submandibular space; a surgical approach with transcervical exploration was performed. The post-operative course was uneventful.     

Neurinoma originating from the recurrent nerve: Report of a case

Schwannoma is an uncommon, peripheral nerve sheath tumor of the neck that can occur either as an isolated lesion or multiple lesions. Multiple schwannomas, as seen in neurofibromatosis, occur less frequently. The rare occurrence and poorly defined symptoms of these tumors often make their preoperative diagnosis difficult. This report describes an unusual case of recurrent nerve Schwannoma which was successfully identified by color Doppler sonography.     

Neurinoma with intrasellar extension: a case report

A 64-year-old female visited Kawatetsu Chiba Hospital complaining of left retro-orbital pain. A month before, she had experienced ptosis and diplopia, that had been releaved two days later by corticosteroid. On admission, she had no neurological deficits except for minimal anisocoria, with the left pupil larger than the right. There was no cutaneous manifestation of von Recklinghausen's disease. Skull X-ray films showed depression of the floor of the sella turcica on the left side. CT scans demonstrated a parasellar enhancing mass with intrasellar extension. Left carotid angiogram showed intracavernous portion of the internal carotid artery displaced laterally, inferiorly, and anteriorly. With a tentative diagnosis of laterally extending pituitary adenoma, a transsphenoidal operation was carried out, which disclosed a solid tumor locating beside the medially-displaced pituitary gland. The histological diagnosis was typical neurinoma. Parasellar neurinoma is not so common. It is usually difficult to determine the origin of the parasellar neurinoma. Trigeminal neurinoma arising from the Gasserian ganglion is generally recognized to be the most frequent. However, the absence of the trigeminal nerve involvement, unusual CT findings, and angiographical changes in the present case were all different from those of the typical trigeminal neurinoma. We believe that the tumor of this case originated from the oculomotor nerve. Fifteen cases of neurinoma of the oculomotor, trochlear, and abducens nerve have been reported to date. Their clinical features were reviewed.     

Isolated bilateral oculomotor nerve palsy in pituitary apoplexy: case report and review

Pituitary tumours usually present with visual field defects; extraocular palsy is usually a sign of cavernous sinus extension and is a sign of advanced disease. We report a case of a pituitary adenoma presenting with complete, bilateral oculomotor nerve palsies, but minimal loss of visual fields, and intact abducens and trochlear nerves.     

A case report of ruptured internal carotid artery aneurysm with contralateral oculomotor nerve paresis

We report a case of ruptured internal carotid artery aneurysm with contralateral oculomotor nerve paresis. A 69-year-old female experienced a sudden onset of severe headache. Left-sided mydriasis, absence of light reflex, disability of left ocular movement and ptosis were identified. Computed tomography scan revealed massive subarachnoid hemorrhage. Cerebral angiography showed a right internal carotid artery aneurysm. No abnormal finding was observed in the left internal carotid artery or basilar artery. Magnetic resonance imaging did not show thrombosed aneurysm. The oculomotor nerve paresis lasted for ten days. Ruptured right internal carotid artery aneurysm was surgically confirmed and repaired. We speculated that the contralateral oculomotor nerve paresis was the consequence of bloody jet flow from the ruptured aneurysm.     

Neurinoma of the oculomotor nerves. Apropos of 2 cases]

The authors report two cases of neurinomas of the oculomotor nerves: one neurinoma of the oculomotor nerve and one of the abducens nerve. The study of 30 cases in the previous literature points out the major striking features of these tumors. Both headaches and oculo-motor palsies are the most regular clinical features. They are not typically suggestive. Therefore the diagnosis is difficult among all the tumors of cavernous sinus and surrounding structures. C.T. scan and M.R.I. with the clinical history should readily allow pre-operative diagnosis. These data are insufficient to distinguish the affected nerve. The surgical treatment is not always complete due to the tumor infiltration into the cavernous sinus.     

Neurinoma of spinal accessory nerve

Neurinomas of the eleventh nerve can be divided into intracisternal and intrajugular types. A 50-year-old woman and a 29-year-old man had neurinomas of the spinal accessory nerve in the cisterna magna which were removed at operation.     

Neurinoma of the third, fourth, and sixth cranial nerves: a survey and report of a new fourth nerve case.

A rare case of trochlear nerve neurinoma is described. Including this case, the number of reported intracranial tumors arising from the sheaths of the third, fourth, and sixth cranial nerves is 38. By site and relationship to the nerve segment, they fall into three groups: cisternal, cisternocavernous, and cavernous. In cisternal tumors of the third and sixth nerves, paresis of the nerve hosting the tumor is the unique nerve deficit; by contrast, in those of the fourth nerve, paresis of the trochlear nerve can be absent and that of the third nerve present. In the latter tumors, a peculiar ataxic hemiparesis syndrome is produced by midbrain compression. Cisternocavernous neurinomas often cause symptoms of intracranial hypertension, while cavernous neurinomas bring about two clinical features: paresis of one or more nerves of the cavernous sinus and a clinicoradiological orbital apex syndrome. At surgery, generally cisternal neurinomas are totally removed and the nerve source of the tumor identified; in cisternocavernous and cavernous neurinomas, total removal of tumor and identification of the parent nerve have been reported in only half of the cases. In the majority of parasellar neurinomas, clinical differences can be found between those arising from the nerves governing eye movement and those arising from the gasserian ganglion.