Cranial Nerves

2019 ◽  
pp. 25-87
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Careful Examination ◽  
Red Flags ◽  
Neoplastic Lesions ◽  
Effects Of Aging

This chapter describes each cranial nerve (CN I through XII) and the Handles and Red Flags associated with disorders of each. These range from trauma, neoplastic lesions, infectious and inflammatory causes, and the effects of aging, to psychological manifestations. Diagnosing disorders of the cranial nerves requires various combinations of history and careful examination.

scholarly journals Resection of a Lower Clival Meningioma via Posterolateral Approach: Two-Dimensional Operative Video

2020 ◽  
Author(s):  
Pinar E. Ocak ◽  
Selcuk Yilmazlar
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Posterolateral Approach ◽  
Left Vertebral Artery ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Two Dimensional ◽  
Lower Cranial Nerve ◽  
Complex Anatomy ◽  
Microsurgical Resection

Abstract Objectives This study aimed to demonstrate resection of a craniovertebral junction (CVJ) meningioma via the posterolateral approach. Design The study is designed with a two-dimensional operative video. Setting This study is conducted at department of neurosurgery in a university hospital. Participants A 50-year-old woman who presented with lower cranial nerve findings due to a left-sided lower clival meningioma (Fig. 1). Main Outcome Measures Microsurgical resection of the meningioma and preservation of the neurovascular structures. Results The patient was placed in park-bench position and a left-sided retrosigmoid suboccipital craniotomy, followed by C1 hemilaminectomy and unroofing the lip of the foramen magnum, was performed. The dural incision extended from the suboccipital region down to the posterior arch of C2 (Fig. 2). The arachnoid overlying the tumor was incised, revealing the course of the cranial nerve (CN) XI on the dorsolateral aspect of the tumor. The left vertebral artery (VA) was encased by the tumor which was originating from the dura below the jugular foramen. The mass was resected in a piecemeal fashion eventually. At the end of the procedure, all relevant cranial nerves and adjacent vascular structures were intact. Postoperative magnetic resonance imaging (MRI) confirmed total resection and the patient was discharged home on postoperative day 3 safely. Conclusions Microsurgical resection of the lesions of the CVJ are challenging as this transition zone between the cranium and upper cervical spine has a complex anatomy. Since adequate exposure of the extradural and intradural segments of the VA can be obtained by the posterolateral approach, this approach can be preferred in cases with tumors anterior to the VA or when the artery is encased by the tumor.The link to the video can be found at: https://youtu.be/d3u5Qrc-zlM.

scholarly journals Intratumoral Bleeding in a Vestibular Schwannoma

2017 ◽  
Vol 37 (01) ◽  
pp. 47-49
Author(s):  
Emanuelle Braga ◽  
Luiza Köhler ◽  
Marcelo de Cesaro ◽  
Tasso Barreto ◽  
Richard Giacomelli ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Cranial Nerve ◽  
Cerebellopontine Angle ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
Altered Consciousness ◽  
Progressive Hearing Loss ◽  
Asymptomatic Patients ◽  
Intratumoral Bleeding

AbstractVestibular schwannomas (VSs) account for ∼ 70% of all tumors of the cerebellopontine angle (CPA). Their clinical presentation is often insidious, with progressive hearing loss and involvement of other cranial nerves. Spontaneous hemorrhage in those tumors is very unusual, and generally presents with acute clinical features such as nausea, vomiting, headache and altered consciousness, usually with marked dysfunction of the cranial nerve involved, and with new deficits of neighboring cranial nerves. Asymptomatic patients are extremely rare. We present a case report of an incidental VS with asymptomatic bleeding, which evolved to death after surgery.

Isolated Congenital Absence of Cranial Nerves: Report of Two Cases

2018 ◽  
Vol 49 (06) ◽  
pp. 405-407
Author(s):  
Vivek Agarwal ◽  
Sumeet Dhawan ◽  
Naveen Sankhyan ◽  
Sameer Vyas
Keyword(s):  
High Resolution ◽  
Mr Imaging ◽  
Cranial Nerve ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
Rare Condition ◽  
Congenital Absence ◽  
The Third ◽  
Seventh Cranial Nerve ◽  
The Right

AbstractIsolated cranial nerve absence is a rare condition that can be diagnosed using high-resolution cranial nerve magnetic resonance (MR) imaging. Thorough clinical examination with proper knowledge of the course of cranial nerves may help diagnose this rare condition. We describe two cases, one each of, isolated congenital absence of the third and seventh cranial nerve with their clinical presentation. High-resolution T2-weighted MR imaging was done in both patients which revealed absence of cisternal segment of the right-sided third nerve and cisternal with canalicular segment of the right-sided facial nerve.

scholarly journals Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

2009 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Amir Ahmad ◽  
◽  
Amir Ahmad ◽  
Philip Travis ◽  
Mark Doran ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Cranial Nerve Palsies

Internal carotid dissection most commonly presents as headache, focal neurological deficits or stroke. Rarely it can manifest itself by causing a palsy of the lower cranial nerves (IX, X, XI, XII). The reported incidence of isolated cranial nerve palsies is rare. We report a case of an internal carotid artery dissection manifesting as isolated XII (hypoglossal) cranial nerve palsy.

scholarly journals A rare case of tuberculoma masquerading as CP Angle neoplasm

2019 ◽  
Vol 10 (4) ◽  
pp. 73-75
Author(s):  
Sinjan Ghosh ◽  
Gautam Guha ◽  
Kaushik Roy ◽  
Annesh Bhattacharjee ◽  
Nikhil Repaka ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Cerebellopontine Angle ◽  
Rare Case ◽  
Nerve Palsy ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions ◽  
Significant Clinical Improvement ◽  
Multiple Cranial Nerve Palsy ◽  
Multiple Cranial Nerve

Tuberculoma involving the cerebellopontine angle is very rare. Preoperative neuroradiological features of such lesions may mimic neoplastic lesions. Our case presented with cerebellar features and multiple cranial nerve palsy. Neuroimaging mimicked CP angle neoplastic lesion. Antitubercular therapy and steroids resulted in significant clinical improvement and marked radiological reduction in size of the lesion. In our subcontinent a treatable infective cause like tuberculosis should be ruled out in CP angle lesions. Although rare but definitely a possibility to be considered.

Unusual presentation of idiopathic intracranial hypertension

2020 ◽  
Vol 13 (5) ◽  
pp. e234741
Author(s):  
Ayman Alboudi ◽  
Emily C Johnson
Keyword(s):  
Intracranial Hypertension ◽  
Lumbar Puncture ◽  
Cranial Nerve ◽  
Idiopathic Intracranial Hypertension ◽  
Cranial Nerves ◽  
Imaging Studies ◽  
Sixth Cranial Nerve ◽  
Orbital Pain ◽  
Atypical Presentations ◽  
Multiple Cranial Nerve

Idiopathic intracranial hypertension typically presents with holocephalic headache associated with nausea, vomiting and bilateral papilledema. Involvement of the sixth cranial nerve is relatively common. The involvement of other cranial nerves, however, is rare in this disorder. We describe a patient with idiopathic intracranial hypertension who presented with episodic unilateral retro-orbital pain and multiple cranial nerve abnormalities without papilledema. Imaging studies excluded alternate diagnoses, and the immediate resolution of symptoms after lumbar puncture confirmed that these symptoms were due to intracranial hypertension. Atypical presentations of such a disabling yet treatable disorder is very important to recognise and address.

scholarly journals Intracranial nonvestibular neurinomas: Young neurosurgeons’ experience

2014 ◽  
Vol 05 (03) ◽  
pp. 231-243
Author(s):  
Forhad Hossain Chowdhury ◽  
Mohammod R. Haque ◽  
Khandkar A. Kawsar ◽  
Mainul H. Sarker ◽  
Mahmudul Hasan ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Craniovertebral Junction ◽  
Jugular Foramen ◽  
Clinical Profile ◽  
Clinical Feature ◽  
Subtotal Resection ◽  
Total Resection

ABSTRACT Background and Objectives: Neurinoma arising from other than nonvestibular cranial nerves is less prevalent. Here we present our experiences regarding the clinical profile, investigations, microneurosurgical management, and the outcome of nonvestibular cranial nerve neurinomas. Materials and Methods: From January 2005 to December 2011, the recorded documents of operated nonvestibular intracranial neurinomas were retrospectively studied for clinical profile, investigations, microneurosurgical management, complications, follow-up, and outcomes. Results: The average follow-up was 24.5 months. Total number of cases was 30, with age ranging from 9 to 60 years. Sixteen cases were males and 14 were females. Nonvestibular cranial nerve schwannomas most commonly originated from trigeminal nerve followed by glossopharyngeal+/vagus nerve. There were three abducent nerve schwannomas that are very rare. There was no trochlear nerve schwannoma. Two glossopharyngeal+/vagus nerve schwannomas extended into the neck through jugular foramen and one extended into the upper cervical spinal canal. Involved nerve dysfunction was a common clinical feature except in trigeminal neurinomas where facial pain was a common feature. Aiming for no new neurodeficit, total resection of the tumor was done in 24 cases, and near-total resection or gross total resection or subtotal resection was done in 6 cases. Preoperative symptoms improved or disappeared in 25 cases. New persistent deficit occurred in 3 cases. Two patients died postoperatively. There was no recurrence of tumor till the last follow-up. Conclusion: Nonvestibular schwannomas are far less common, but curable benign lesions. Surgical approach to the skull base and craniovertebral junction is a often complex and lengthy procedure associated with chances of significant morbidity. But early diagnosis, proper investigations, and evaluation, along with appropriate decision making and surgical planning with microsurgical techniques are the essential factors that can result in optimum outcome.

Instant Neurological Diagnosis

2019 ◽  
Author(s):  
Christopher H. Hawkes ◽  
Kapil D. Sethi ◽  
Thomas R. Swift
Keyword(s):  
Cerebrospinal Fluid ◽  
Peripheral Neuropathy ◽  
Video Clip ◽  
Cranial Nerves ◽  
Red Flags ◽  
Spinal Lesions ◽  
Salient Points ◽  
The Right ◽  
Initial Impressions

Experienced neurologists work fast. They ask few questions, maybe perform a brief examination, and they come up with the right answer. Sometimes they do neither and their conclusions are accurate—but how do they do it? This book holds the answers. The book is divided into 14 chapters which, for the most part, focus on a particular neurologic condition, namely: demyelination, headache, epilepsy and sleep, myopathy and motor neuron disorders, movement disorders, stroke, peripheral neuropathy, cerebellar ataxia, and dementia. The remaining chapters are concerned with the clinician’s initial impressions (first encounters), cranial nerves, limbs and trunk, spinal lesions, and cerebrospinal fluid. At the end of each chapter is a summary of the salient points and a few key references. The final chapter relates to the fast neurological examination. Most diagnostic clues or “Handles” are illustrated by a table, figure, or video clip to reinforce a particular message, and the text is marked with Red Flags that the clinician must be alert for.

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