1/246. Surgical management of lesions affecting the anterior optic pathways.Although benign neoplasms are the most common lesions of the anterior visual pathways that lend themselves to a combined neurosurgical and ophthalmic surgical treatment, malignant neoplasms, infections (especially fungal), and vascular lesions are also sometimes treated via a combined approach. Recent advances in the field of skull base surgery have made it possible to treat complicated lesions in precarious locations with increasing margins of safety and decreasing morbidity. The role of the neurosurgeon in managing selected patients with lesions of the anterior a visual pathway should not be underestimated.- - - - - - - - - - ranking = 1keywords = optic (Clic here for more details about this article) |
2/246. Spontaneous partial regression of low-grade glioma in children with neurofibromatosis-1: a real possibility.At the age of 41 and 31 months, respectively, a boy and a girl affected by neurofibromatosis-1 were diagnosed with a visual pathway glioma during surveillance contrast-enhanced head magnetic resonance imaging (MRI). In the first child, the initial MRI showed that the entire optic chiasm, the intracranial tract of the left optic nerve, and hypothalamus were grossly enlarged and enhanced in the post-gadolinium T1-weighted images. Ten months later, the hypothalamic component of the lesion had regressed markedly and there were no more areas of contrast enhancement. In the second child, the initial MRI showed that the optic chiasm, the right optic tract, and geniculate body were enlarged and enhanced after gadolinium injection. At 6-month follow-up, the MRI showed that the right optic tract and the anterior aspect of the optic chiasm decreased in size and the contrast enhancement of the entire lesion was reduced dramatically. These findings, as indicated by other similar reports, confirm that spontaneous regression of visual pathway glioma is a rare but real possibility in children with neurofibromatosis-1. Therefore, clinicians need to be aware of visual pathway glioma's erratic behavior in children with neurofibromatosis-1 with special attention given to the importance of a very conservative attitude toward any type of treatment for such patients.- - - - - - - - - - ranking = 1.5keywords = optic (Clic here for more details about this article) |
3/246. ganglioglioma of the trigeminal nerve: MRI.ganglioglioma of the cranial nerves is extremely rare; only a few cases involving the optic nerves have been reported. We present a case of ganglioglioma of the trigeminal nerve, which was isointense with the brain stem on all MRI sequences and showed no contrast enhancement.- - - - - - - - - - ranking = 0.25keywords = optic (Clic here for more details about this article) |
4/246. Cavernous angioma of the optic chiasm--case report.A 31-year-old female presented with cavernous angioma originating from the optic chiasm manifesting as sudden onset of right retroorbital pain and right visual disturbance. She had a psychomotor seizure 10 years ago. Cavernous angioma at the right basal ganglia had been partially removed at that time. After the operation, the patient had left hemiparesis, but gradually improved. Neurological examination revealed decreased right visual acuity, left homonymous hemianopsia, and left hemiparesis. magnetic resonance imaging revealed a mixed signal intensity mass at the right optic nerve to the optic chiasm with a low signal intensity rim on T2-weighted imaging, situated at the right basal ganglia where the cavernous angioma had been partially resected. Right frontotemporal craniotomy was performed by the pterional approach. A subpial hematoma was situated at the right optic nerve to the optic chiasm. The hematoma with an angiomatous component was completely resected from the surrounding structure. Histological examination of the specimens confirmed cavernous angioma. Postoperatively, her right visual acuity was slightly improved, but the visual field defect was unchanged. We emphasize the importance of correct diagnosis by magnetic resonance imaging and subsequent resection for preserving and improving the visual function of patients with cavernous angiomas of the optic chiasm.- - - - - - - - - - ranking = 2.5keywords = optic (Clic here for more details about this article) |
5/246. Hypoglossal schwannoma: an uncommon cause of twelfth-nerve palsy.Hypoglossal schwannoma is an uncommon cause of 12th nerve palsy. We here report a pathologically proven case of left 12th nerve schwannoma in a 56-year-old woman who presented with progressive left tongue hemiatrophy and in whom cranial MRI disclosed a mass near the foramen jugular. Surgery showed a mass involving the hypoglossal nerve and the pathological examination was diagnostic of schwannoma.- - - - - - - - - - ranking = 0.0011547372602207keywords = atrophy (Clic here for more details about this article) |
6/246. Type II neurofibromatosis presenting as quadriceps atrophy.A young woman aged 26 years presented with atrophy of the left quadriceps progressing over one year. magnetic resonance imaging (MRI) showed a large lesion of the lumbar plexus compatible with neurinoma. Cerebral MRI revealed a lesion in the right eighth cranial nerve also compatible with neurinoma. On further questioning of the patient, it was learned that her mother had undergone surgery twice for acoustic neurinoma. Type II neurofibromatosis was diagnosed from the basis of clinical picture, neuroimaging findings and family history. This case is unusual for the lack of central nervous system (CNS) symptoms. Expansive radicular lesions compatible with neurinoma should prompt cerebral MRI. Regular examination of family members at risk and early diagnosis can decrease the high mortality associated with this condition.- - - - - - - - - - ranking = 0.0057736863011033keywords = atrophy (Clic here for more details about this article) |
7/246. Oral ulcerations as the first sign of a foramen magnum meningioma.We report the case of a patient with oral ulcerations that were likely traumatic in origin caused by biting of the tongue. physical examination showed only deviation, fasciculations, and hemiatrophy of the right side of the tongue. neurologic examination disclosed an isolated XII nerve palsy. A magnetic resonance image showed a lesion in the posterior fossa displacing the brain stem at a bulbar level. This was consistent with the diagnosis of a meningioma, later confirmed by the histopathologic study. It is very unusual that a meningioma produces a selective involvement of the XII nerve. early diagnosis of a foramen magnum meningioma is important, both to improve prognosis and to avoid neurologic sequelae.- - - - - - - - - - ranking = 0.0011547372602207keywords = atrophy (Clic here for more details about this article) |
8/246. denervation atrophy of the masticatory muscles in a patient with nasopharyngeal cancer: MR examinations before and after radiotherapy.We report on a patient with denervation atrophy of the masticatory muscles due to nasopharyngeal cancer who received therapeutic irradiation. magnetic resonance imaging has significantly contributed to aid diagnosis of this pathology. Masticatory muscle atrophy should be a definitive finding of perineural invasion caused by head and neck tumors. Radiologists should be familiar with this appearance to avoid confusion with tumor invasion of the muscle.- - - - - - - - - - ranking = 0.0069284235613239keywords = atrophy (Clic here for more details about this article) |
9/246. Unusual case of multiple cellular and malignant schwannomas of the cranial and spinal nerves.Schwannomas from cranial nerves and spinal roots are most often benign, malignant schwannomas being uncommon in this location. This report describes a unique case of multiple cellular and malignant schwannomas of the cranial and spinal nerves in a patient with features of neurofibromatosis 2. The tumors were arising from left optic, bilateral oculomotor, trochlear, abducent and vestibular nerves, the left facial and the spinal lumbar nerve roots. The tumor arising from the right trochlear nerve was seen excavating into the hippocampus and the left vestibular nerve into the medulla. In addition, the patient had nodular schwannomas adherent to the inferior surface of the optic chiasm and the cerebellum away from the cranial nerves. Hyperplastic schwannosis was noted in perivascular spaces of thalamus, cerebellum and hippocampus on both sides away from the main lesions. The immunohistochemical and ultrastructural profiles of the tumors suggest that neurofibromas and schwannomas are probably not distinct tumors but lie within a spectrum that differs histologically depending on the predominant cell type.- - - - - - - - - - ranking = 0.5keywords = optic (Clic here for more details about this article) |
10/246. Schwannoma of the spinal accessory nerve in the cisterna magna.BACKGROUND: Intracranial schwannoma of the accessory nerve can be divided into two types. One is a jugular foramen type arising from the accessory nerve of the jugular foramen, while the other is an intracisternal type, which arises from the spinal root of the accessory nerve and is separate from the jugular foramen. The latter type is rare, and only 9 cases have been reported previously. CASE DESCRIPTION: A 46-year-old female presented with a large, midline mass lesion in the posterior fossa manifesting as foramen magnum syndrome. magnetic resonance imaging (MRI) revealed a huge tumor with cystic lesion located in the cisterna magna with extension to the C1 spinal level. The tumor was totally removed by a suboccipital craniectomy and C1 laminectomy. It originated from the spinal root of the right accessory nerve. Temporary slight atrophy of the right sternocleidomastoid muscle was observed, but the patient was free of disease 2 years after treatment. CONCLUSIONS: We report a schwannoma of the spinal accessory nerve in the cisterna magna. The clinical and neuroradiological findings are discussed with a review of the literature. The initial symptoms were variable without loss of function of the cranial nerve, and the tumor tended to grow in the cisterna magna without laterality. Because of the absence of typical neurologic symptoms, early neuroradiological investigation by MRI is recommended for accurate diagnosis of these tumors.- - - - - - - - - - ranking = 0.0011547372602207keywords = atrophy (Clic here for more details about this article) |
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