Malignant meningioma of the oculomotor nerve without dural attachment

1998 ◽  
Vol 88 (6) ◽  
pp. 1104-1106 ◽  
Author(s):  
Alister J. Hart ◽  
James Allibone ◽  
Adrian T. H. Casey ◽  
David G. T. Thomas

✓ Meningiomas, thought to arise from arachnoid cap cells, are usually attached to the dura. Malignancy is present in approximately 1% of these tumors. The authors report the case of a patient with a malignant meningioma arising from the oculomotor nerve with no dural attachment. The patient presented with a 7-month history of left-sided ptosis and diplopia. Magnetic resonance imaging demonstrated an extrinsic mass compressing the root of the oculomotor nerve at its exit from the midbrain. During surgery, a left-sided subtemporal approach revealed the tumor to be arising from the oculomotor nerve. Histological investigation showed a malignant spindle cell lesion with an immunohistochemical profile that was consistent with malignant meningioma. To the authors' knowledge, this is the first documented case of a malignant meningioma arising from the oculomotor nerve.

2005 ◽  
Vol 102 (3) ◽  
pp. 482-488 ◽  
Author(s):  
Hisham Al-Khayat ◽  
Haitham Al-Khayat ◽  
Jonathan White ◽  
David Manner ◽  
Duke Samson

Object. The purpose of this study was to identify factors predictive of postoperative oculomotor nerve palsy among patients who undergo surgery for distal basilar artery (BA) aneurysms. The data can be used to estimate preoperative risk in this population. The natural history of oculomotor nerve palsy in patients with good outcomes is also defined. Methods. The cases of 163 patients with distal BA aneurysms, who were treated surgically between 1996 and 2002, were retrospectively studied to identify factors contributing to oculomotor nerve palsy. After the data had been collected, stepwise logistic regression procedures were used to determine the predictive effects of each variable on the development of oculomotor nerve palsy and to create a scoring system. Factors that interfered with resolution of oculomotor dysfunction in patients with good outcomes were also studied. Postoperative oculomotor nerve palsy occurred in 86 patients (52.8%) with distal BA aneurysms. The following factors were associated with postoperative oculomotor dysfunction, as determined by a categorical data analysis: 1) younger patient age (p < 0.001); 2) poor admission Hunt and Hess grade (p < 0.001); 3) use of temporary arterial occlusion (p < 0.001); 4) poor Glasgow Outcome Scale score (p < 0.001); and 5) the presence of a BA apex aneurysm that projected posteriorly (p < 0.001). For patients with good outcomes, postoperative oculomotor nerve palsy resolved completely within 3 months in 31 patients (52%) and within 6 months in 47 patients (80%). The projection of the BA aneurysm was associated with incomplete oculomotor recovery at 6 months postoperatively (p = 0.019). Conclusions. The results of this study can help identify patients with a high risk for the development of oculomotor nerve palsy. This may help neurosurgeons in preoperative planning and discussions.


1994 ◽  
Vol 81 (5) ◽  
pp. 788-791 ◽  
Author(s):  
Gabriel Lena ◽  
Thierry Dufour ◽  
Danielle Gambarelli ◽  
Brigitte Chabrol ◽  
Josette Mancini

This report describes what the authors believe to be the first reported case of choristoma of the intracranial maxillary nerve. This 12-year-old girl presented with a 5-year history of severe isolated left-sided trigeminal neuralgia. Computerized tomography and magnetic resonance imaging revealed a mass below the anterior portion of the left cavernous sinus, enlarging the foramen rotundum. Total resection was achieved via a pterional extradural approach. Histological examination revealed a choristoma composed of smooth-muscle fibers. The histogenesis of these tumors when they develop in a nerve remains unclear. They may represent abnormal migration or proliferation of neuroectodermal tissue in or close to a peripheral nerve. Total removal of these tumors should be attempted at initial diagnosis.


2005 ◽  
Vol 2 (5) ◽  
pp. 601-603 ◽  
Author(s):  
Tjokorda Mahadewa ◽  
Harsan Harsan ◽  
Setyowidi Nugroho ◽  
Mark Bernstein

✓ The authors present a rare case of acute complete paraplegia due to a lumbar schwannoma. The clinical presentation, magnetic resonance imaging features, and management strategy are discussed. A 29 year-old man presented with acute complete paraplegia and bladder and bowel incontinence. He had a history of stable back pain and a 4-year history of lower-extremity numbness bilaterally. Magnetic resonance imaging revealed an enhancing extraaxial mass filling the spinal canal over two segments below the conus medullaris. An L1–3 laminectomy was performed and the tumor was completely removed. Pathological evaluation showed features characteristic of a schwannoma. The patient regained almost complete motor function after 6 months. To the authors' knowledge, this is the first reported case of acute complete paraplegia secondary to lumbar schwannoma. Possible mechanisms of this occurrence are discussed.


2005 ◽  
Vol 103 (6) ◽  
pp. 1084-1087 ◽  
Author(s):  
Adrian W. Laxton ◽  
Patrick Shannon ◽  
Sukriti Nag ◽  
Richard I. Farb ◽  
Mark Bernstein

✓ This 39-year-old man presented with a 6-month history of occipital headaches. Magnetic resonance imaging revealed an irregularly shaped fourth ventricle mass. One month after his initial presentation, he was admitted to the hospital with significant tumor expansion and clinical deterioration. A posterior fossa craniectomy was performed and the mass was resected. Histopathological analysis of this tumor showed central necrosis with associated edema in an otherwise typical and benign-appearing subependymoma. To the authors' knowledge, this is the first reported case of rapid, nonhemorrhagic expansion associated with necrosis in a previously asymptomatic subependymoma.


2002 ◽  
Vol 97 ◽  
pp. 533-535 ◽  
Author(s):  
Jin Woo Chang ◽  
Jae Young Choi ◽  
Young Sul Yoon ◽  
Yong Gou Park ◽  
Sang Sup Chung

✓ The purpose of this paper was to present two cases of secondary trigeminal neuralgia (TN) with an unusual origin and lesion location. In two cases TN was caused by lesions along the course of the trigeminal nerve within the pons and adjacent to the fourth ventricle. Both cases presented with typical TN. Brain magnetic resonance imaging revealed linear or wedge-shaped lesions adjacent to the fourth ventricle, extending anterolaterally and lying along the pathway of the intraaxial trigeminal fibers. The involvement of the nucleus of the spinal trigeminal tract and of the principal sensory trigeminal nucleus with segmental demyelination are suggested as possible causes for trigeminal pain in these cases. It is postulated that these lesions are the result of an old viral neuritis. The patients underwent gamma knife radiosurgery and their clinical responses have been encouraging to date.


1997 ◽  
Vol 86 (6) ◽  
pp. 1046-1048 ◽  
Author(s):  
Marc S. Arginteanu ◽  
Karin Hague ◽  
Robert Zimmerman ◽  
Mark J. Kupersmith ◽  
John H. Shaiu ◽  
...  

✓ The authors report the case of a 55-year-old woman who developed a symptomatic craniopharyngioma within 2 years of obtaining a normal magnetic resonance image of her brain. Craniopharyngiomas are histologically benign tumors. They are thought to arise from embryonic remnants of Rathke's pouch and sac and to manifest themselves clinically after a steady growth that commences in fetal life. To the authors' knowlege, this is the first report that documents a tumor arising de novo in the sixth decade of life. This report appears to challenge the concept of the origin and natural history of craniopharyngiomas.


1994 ◽  
Vol 81 (4) ◽  
pp. 595-600 ◽  
Author(s):  
Thomas J. Manski ◽  
Charles S. Ha worth ◽  
Bertrand J. Duval-Arnould ◽  
Elisabeth J. Rushing

✓ The authors report gigantism in a 16-month-old boy with an extensive optic pathway glioma infiltrating into somatostatinergic pathways, as revealed by magnetic resonance imaging and immunocytochemical studies. Stereotactic biopsies of areas showing hyperintense signal abnormalities on T2-weighted images in and adjacent to the involved visual pathways provided rarely obtained histological correlation of such areas. The patient received chemotherapy, which resulted in reduction of size and signal intensity of the tumor and stabilization of vision and growth velocity.


1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.


1994 ◽  
Vol 80 (5) ◽  
pp. 935-938 ◽  
Author(s):  
Jeffrey S. Oppenheim

✓ The Mount Sinai Hospital was founded in 1852 under the name “The Jews' Hospital.” Neurosurgery at Mount Sinai Hospital can be traced to the work of Dr. Charles Elsberg. In 1932, the Department of Neurosurgery was created under the direction of Dr. Ira Cohen. The history of neurosurgery at the Mount Sinai Hospital is recounted.


1994 ◽  
Vol 81 (5) ◽  
pp. 784-787 ◽  
Author(s):  
Markus Hardenack ◽  
Anje Völker ◽  
J. Michael Schröder ◽  
Joachim M. Gilsbach ◽  
Albrecht G. Harders

The authors report the occurrence of primary eosinophilic granuloma of the oculomotor nerve without osseous involvement in a 68-year-old man. Histopathological and neuroradiological findings are discussed. This case demonstrates that eosinophilic granuloma should be included in the differential diagnosis of tumor in which cranial nerves are involved.


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