Foramen magnum schwannoma with an unusual clinical presentation: case report

Sairyo, Koichi; Henmi, Tatsuhiko; Endo, Hisao

doi:10.1038/sj.sc.3100431

Cited by 7 publications

(3 citation statements)

References 2 publications

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“…5,11,13,20,32,38,54,59,60,71,81,88,96,104 In published series of spinal nerve sheath tumors, 5,11,32,34,38,39,44,49,54,59,71,81,88,91,96,104 extradural tumors have not been systematically addressed, being given no more than passing attention and being noted mainly in association with descriptions of the more frequent intradural and intradural-extradural tumors. With some exceptions, 61 reports of extradural nerve sheath tumors, published sporadically since 1914, 7 have involved single or only a few cases, mainly reported as examples of benign epidural lesions 76,97 or to illustrate peculiar clinicoradiological features, 6,10,18,31,45,50,58,62,75,77,87,92,101,…”

Section: Spinal Extradural Schwannomasmentioning

confidence: 99%

“…XTRADURAL schwannomas have not been the focus of investigation in the series of spinal nerve sheath tumors 5,11,12,20,32,34,38,39,44,46,49,54,59,71,81,88,91,95,96 and have been the subject of relatively little study in general, being more often described in a single case report or small series. 6,7,10,15,18,31,33,36,45,50,51,58,62,[65][66][67][75][76][77]85,87,92,97,101,102 Their clinical profile, therefore, is not clearly defined. In recent years we have surgically treated a number of patients with cervical and thoracic extradural schwannomas, in whom the pathological tissue was found to be totally outside the nerve roots and the tumor could be radically removed while conserving nerve root integrity.…”

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Spinal extradural schwannoma

Celli

Trillò²,

Ferrante³

2005

Journal of Neurosurgery: Spine

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Object. The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve. Methods. A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed. Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk. Conclusions. Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.

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Section: Spinal Extradural Schwannomasmentioning

confidence: 99%

mentioning

confidence: 99%

Spinal extradural schwannoma

Celli

Trillò²,

Ferrante³

2005

Journal of Neurosurgery: Spine

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“…Symptoms and signs are usually diagnostic in nature. However, unusual symptoms of syncopal attacks, migraine headaches, and unrelated motor & sensory symptoms, can lead to misdiagnosis (2,(20)(21)(22)(23)(24) . In one of our case there was history of syncopal attack and fall.…”

Section: Discussionmentioning

confidence: 99%

Microneurosurgical Management of Upper Cervical Spinal Schwannoma: An Experience of 30 Cases

Rahman

Mitra

Habib

et al. 2019

Bangla J. Neurosurgery

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Aim: We prospectively recorded the clinical features, radiological features, surgical approaches & findings, postoperative follow up & ultimate neurological outcome of upper cervical spinal schwannomas and then we evaluated the records retrospectively. Materials and Method: 30 upper cervical spinal schwannomas patient who underwent surgery (microneurosurgically) from 2007 to 2014 in the department of neurosurgery Dhaka Medical College and private hospitals are included in this retrospective study. After operation all patients were followed up regularly both clinically and neuro-radiologically. Results: Out of 30 cases 16 male and 14 females. The male to female ratio was 1.4: 1, Age range from 8 to 60 years with mean age 35 Years. Most of the patients are in middle years age group The mean duration of symptoms at the time of presentation was 32 months (range 06 months-5 years). Four schwannomas were completely extradural, fourteen were intradural and rest twelve were intradural or hourglass type (both extra and intradural) as identified during surgery. The posterior midline approach was used in all patients. A C2 hemilaminectomy or C2 laminectomy with or without cutting of posterior arch of atlas was used for most intradural and large in terdural C2 schwannomas. Tumor removal was complete in all cases. Preservation of the nerve root fibers was not possible in 18 cases and was possible only in 12 cases. In one patients CSF leak developed after operation. One patient who had severe myelopathic features with bed sore failed to improve and expired 5 months after operation. Rest of the patients showed postoperative improvement in their preoperative symptoms and returned to their normal life by the end of sixth month. There was one tumor recurrence in any patient till last follow up. Conclusion: Proper 3-D anatomical orientation & physiological knowledge, deep neuro-radiological observation, pathological appreciations and micro-neurosurgical skill and expertization can make the surgical management of these tumors ( in a surgically complex site) simple with gratifying result (i.e.neurological outcome) without extensive bone removal or soft tissue manipulation through a standard midline posterior approach. Bang. J Neurosurgery 2019; 9(1): 44-48

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