EFFECT ON RESPIRATION, BLOOD PRESSURE AND CAROTID PULSE OF VARIOUS INHALED AND INSUFFLATED VAPORS WHEN STIMULATING ONE CRANIAL NERVE AND VARIOUS COMBINATIONS OF CRANIAL NERVES

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.

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Intratumoral Bleeding in a Vestibular Schwannoma

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0037-1615287 ◽

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.

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Isolated Congenital Absence of Cranial Nerves: Report of Two Cases

Neuropediatrics ◽

10.1055/s-0038-1669923 ◽

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.

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Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

Acute Medicine Journal ◽

10.52964/amja.0226 ◽

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.

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Cranial Nerves

Instant Neurological Diagnosis ◽

10.1093/med/9780190930868.003.0002 ◽

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.

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Unusual presentation of idiopathic intracranial hypertension

BMJ Case Reports ◽

10.1136/bcr-2020-234741 ◽

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.

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Intracranial nonvestibular neurinomas: Young neurosurgeons’ experience

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-1700320 ◽

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.

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Cranial nerves

10.1093/med/9780199551002.003.0006 ◽

2018 ◽

Author(s):

Arangasamy Anbarasu ◽

Jack I. Lane

Keyword(s):

Cranial Nerve ◽

Special Functions ◽

Cranial Nerves ◽

Facial Movement ◽

The Brain

This section discusses the cranial nerve. Cranial nerves are important structures involved with special functions of smell, sight, lacrimation, hearing, balance, taste, facial movement, mastication and swallowing. There are twelve pairs of cranial nerves which are named anatomically by the level at which they exit the brain and brainstem, with lower numbered cranial nerves exiting superior and anterior to higher numbered ones.

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