Trochlear Nerve Schwannoma with Intratumoral Hemorrhage: Case Report

Neurosurgery ◽  
2006 ◽  
Vol 58 (4) ◽  
pp. E791-E791 ◽  
Author(s):  
Shigeo Ohba ◽  
Tomoru Miwa ◽  
Takeshi Kawase
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Nerve Palsy ◽  
Clinical Presentation ◽  
Resonance Imaging ◽  
Trochlear Nerve ◽  
Total Removal ◽  
Intratumoral Hemorrhage ◽  
Anterior Transpetrosal Approach ◽  
Trochlear Nerve Palsy

Abstract OBJECTIVE AND IMPORTANCE: Schwannomas originating from the trochlear nerve without neurofibromatosis are extremely rare. Thirty-four cases have previously been reported in the literature, and only 25 cases were pathologically diagnosed. In addition, intratumoral hemorrhage in intracranial schwannomas is also rare. Approximately 30 cases of intracranial schwannomas with intratumoral hemorrhage have been reported. CLINICAL PRESENTATION: A 42-year-old man presented with left hemiparesis and right trochlear nerve palsy. Magnetic resonance imaging revealed an abnormal cystic lesion beside the brainstem. His symptoms rapidly worsened after enlargement of the mass because of intratumoral hemorrhage. INTERVENTION: Gross total removal of the tumor was performed via the anterior transpetrosal approach. The tip of the trochlear nerve was fanned out and unified with the tumor. The tumor was diagnosed as a schwannoma. CONCLUSION: The patient's hemiparesis improved postoperatively, and he was discharged 1 week after the operation. Magnetic resonance imaging performed 4 months later revealed no regrowth of the tumor. Only right trochlear nerve palsy has persisted. This report is the second case of intratumoral hemorrhage from a trochlear nerve schwannoma.

Traumatic Trochlear Nerve Palsy Diagnosed by Magnetic Resonance Imaging: Case Report and Review of the Literature

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 978-981 ◽  
Author(s):  
Robert S. Burgerman ◽  
Aizik L. Wolf ◽  
Shalom E. Kelman ◽  
Henry Elsner ◽  
Stuart Mirvis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Imaging ◽  
Nerve Palsy ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Trochlear Nerve ◽  
Trochlear Nerve Palsy ◽  
Resonance Imaging Scan ◽  
Superior Oblique

Abstract Although head trauma is the leading cause of acquired trochlear nerve dysfunction, it receives little attention in the neurosurgical literature. A case is reported of closed head injury that resulted in a right superior oblique palsy in association with incoordination on the left side. Diagnostic imaging revealed a normal cranial computed tomographic scan and a left dorsal midbrain lesion on magnetic resonance imaging scan. The relevant anatomy is reviewed, as well as the action of the superior oblique muscle, its agonists and antagonists, and the clinical manifestations of superior oblique dysfunction. This case is one of the few we are aware of in which a relatively isolated trochlear nerve palsy is the result of a lesion that can be documented by diagnostic imaging, and the first in which the imaging modality is magnetic resonance imaging scan.

Traumatic trochlear nerve palsy diagnosed by magnetic resonance imaging

Neurosurgery ◽  
1989 ◽  
pp. 978 ◽  
Author(s):  
R S Burgerman ◽  
A L Wolf ◽  
S E Kelman ◽  
H Elsner ◽  
S Mirvis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Nerve Palsy ◽  
Resonance Imaging ◽  
Trochlear Nerve ◽  
Trochlear Nerve Palsy

Accessory Soleus Muscle

2004 ◽  
Vol 94 (6) ◽  
pp. 587-589 ◽  
Author(s):  
Tuba Karagülle Kendi ◽  
Aziz Erakar ◽  
Olcay Oktay ◽  
H. Yusuf Yildiz ◽  
Yener Saglik
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Soleus Muscle ◽  
Clinical Presentation ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Tissue Mass ◽  
Anatomical Variant ◽  
Muscle Magnetic Resonance Imaging

Accessory soleus muscle is an uncommon anatomical variant that may present as a soft-tissue mass in the posteromedial region of the ankle. It is congenital in origin but usually presents in the second or third decade of life. Although it is a rare entity, accessory soleus muscle should be included in the differential diagnosis of soft-tissue swelling of the ankle. Awareness of the clinical presentation and specific findings of computed tomography, magnetic resonance imaging, and electromyography help with diagnosis without surgical exploration. We describe a 30-year-old patient with accessory soleus muscle. Magnetic resonance imaging features of the case are described, and the literature is briefly reviewed. (J Am Podiatr Med Assoc 94(6): 587–589, 2004)

Imaging appearances of toxic and acquired metabolic encephalopathic disorders

2019 ◽  
Vol 80 (7) ◽  
pp. 372-376
Author(s):  
Tharunniya Vamadevan ◽  
David Howlett ◽  
Maria Filyridou
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Metabolic Disorders ◽  
Clinical Presentation ◽  
Carbon Monoxide Poisoning ◽  
District General Hospital ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Diagnostic Uncertainty ◽  
Pictorial Review

Most imaging findings relating to toxic and acquired metabolic disorders follow a certain pattern with affinity to a specific topographic area, which can help narrow the differential diagnosis. This is especially useful when the clinical presentation can be variable and there is diagnostic uncertainty. Usually, there is bilateral symmetrical abnormality within the deep grey matter structures and the cerebral cortex because of the high metabolic activity and raised oxygen requirements in these areas. Magnetic resonance imaging, particularly diffusion weighted imaging and fluid-attenuated inversion recovery sequences, is very important in differentiating between various aetiologies in this group. Magnetic resonance imaging can be useful in demonstrating both acute and chronic damage, in evaluating treatment response and in disease prognostication. This pictorial review discusses the computed tomography and magnetic resonance imaging appearances of a spectrum of toxic and metabolic disorders observed in a district general hospital with reference to clinical presentation and imaging features that may allow diagnosis. This includes carbon monoxide poisoning, hypoglycaemia, non-ketotic hyperglycaemia, osmotic demyelination syndrome, posterior reversible encephalopathy syndrome, hypoxic ischaemic encephalopathy, the syndrome of delayed post-hypoxic leukoencephalopathy, hepatic encephalopathy and cocaine toxicity.

scholarly journals Bilateral facial nerve involvement in a patient with Tolosa–Hunt syndrome

2020 ◽  
Vol 33 (5) ◽  
pp. 424-427
Author(s):  
Ajay A Madhavan ◽  
David R DeLone ◽  
Jared T Verdoorn
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Cranial Nerves ◽  
Corticosteroid Treatment ◽  
Resonance Imaging ◽  
Hunt Syndrome ◽  
Facial Nerves

Tolosa–Hunt syndrome is characterized by unilateral retro-orbital headaches and cranial nerve palsies, usually involving cranial nerves III–VI. It is rare for other cranial nerves to be involved, although this has previously been reported. We report a 19-year-old woman presenting with typical features of Tolosa–Hunt syndrome but ultimately developing bilateral facial nerve palsies and enhancement of both facial nerves on magnetic resonance imaging. The patient presented with unilateral retro-orbital headaches and palsies of cranial nerves III–VI. She was diagnosed with Tolosa–Hunt syndrome but was non-compliant with her corticosteroid treatment due to side effects. She returned with progressive left followed by right facial nerve palsy. Her corresponding follow-up magnetic resonance imaging scans showed sequential enhancement of the left and right facial nerves. She ultimately had clinical improvement with IV methylprednisolone. To our knowledge, Tolosa–Hunt syndrome associated with bilateral facial nerve palsy and corroborative facial nerve enhancement on magnetic resonance imaging has not previously been described. Moreover, our patient’s clinical course is instructive, as it demonstrates that this atypical presentation of Tolosa–Hunt syndrome can indeed respond to corticosteroid treatment and should not be mistaken for other entities such as Bell’s palsy.

Sign in / Sign up

Export Citation Format

Share Document