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Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case

BACKGROUND: A vestibular schwannoma (VS) presenting with paroxysmal facial electric shock pain, that is, trigeminal neuralgia (TN), is relatively rare. Furthermore, TN is extremely rare in small VSs. OBSERVATIONS: Herein, the authors report the case of a 52-year-old woman with a complaint of right T...

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Autores principales: Onoda, Keisuke, Ogasawara, Yoshifumi, Hirokawa, Yu, Sashida, Ryohei, Fujiwara, Ren, Wakamiya, Tomihiro, Michiwaki, Yuhei, Tanaka, Tatsuya, Shimoji, Kazuaki, Suehiro, Eiichi, Yamane, Fumitaka, Kawashima, Masatou, Matsuno, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Association of Neurological Surgeons 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426354/
https://www.ncbi.nlm.nih.gov/pubmed/36051778
http://dx.doi.org/10.3171/CASE22274
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author Onoda, Keisuke
Ogasawara, Yoshifumi
Hirokawa, Yu
Sashida, Ryohei
Fujiwara, Ren
Wakamiya, Tomihiro
Michiwaki, Yuhei
Tanaka, Tatsuya
Shimoji, Kazuaki
Suehiro, Eiichi
Yamane, Fumitaka
Kawashima, Masatou
Matsuno, Akira
author_facet Onoda, Keisuke
Ogasawara, Yoshifumi
Hirokawa, Yu
Sashida, Ryohei
Fujiwara, Ren
Wakamiya, Tomihiro
Michiwaki, Yuhei
Tanaka, Tatsuya
Shimoji, Kazuaki
Suehiro, Eiichi
Yamane, Fumitaka
Kawashima, Masatou
Matsuno, Akira
author_sort Onoda, Keisuke
collection PubMed
description BACKGROUND: A vestibular schwannoma (VS) presenting with paroxysmal facial electric shock pain, that is, trigeminal neuralgia (TN), is relatively rare. Furthermore, TN is extremely rare in small VSs. OBSERVATIONS: Herein, the authors report the case of a 52-year-old woman with a complaint of right TN. Magnetic resonance (MR) imaging revealed a right VS of 12-mm diameter that compressed the trigeminal nerve. Although she did not report any hearing impairment, audiometry revealed decreased high-frequency range on the right side. The tumor was excised using the right retrosigmoid approach, and TN was confirmed to be caused by direct compression of the trigeminal nerve by the VS. Sufficient decompression of trigeminal nerve was done. The proximity of the trigeminal nerve root to the vestibular nerve root was the cause of TN. TN disappeared immediately after surgery, and there was no worsening of hearing impairment and facial paralysis. LESSONS: It is important to remember that TN may occur with direct tumor compression, even in small VSs. A preoperative 3-dimensional MR cisternogram/angiogram fusion image clearly showed direct tumor compression of the trigeminal nerve and the absence of responsible vessels, which was useful for surgical planning.
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spelling pubmed-94263542022-08-31 Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case Onoda, Keisuke Ogasawara, Yoshifumi Hirokawa, Yu Sashida, Ryohei Fujiwara, Ren Wakamiya, Tomihiro Michiwaki, Yuhei Tanaka, Tatsuya Shimoji, Kazuaki Suehiro, Eiichi Yamane, Fumitaka Kawashima, Masatou Matsuno, Akira J Neurosurg Case Lessons Case Lesson BACKGROUND: A vestibular schwannoma (VS) presenting with paroxysmal facial electric shock pain, that is, trigeminal neuralgia (TN), is relatively rare. Furthermore, TN is extremely rare in small VSs. OBSERVATIONS: Herein, the authors report the case of a 52-year-old woman with a complaint of right TN. Magnetic resonance (MR) imaging revealed a right VS of 12-mm diameter that compressed the trigeminal nerve. Although she did not report any hearing impairment, audiometry revealed decreased high-frequency range on the right side. The tumor was excised using the right retrosigmoid approach, and TN was confirmed to be caused by direct compression of the trigeminal nerve by the VS. Sufficient decompression of trigeminal nerve was done. The proximity of the trigeminal nerve root to the vestibular nerve root was the cause of TN. TN disappeared immediately after surgery, and there was no worsening of hearing impairment and facial paralysis. LESSONS: It is important to remember that TN may occur with direct tumor compression, even in small VSs. A preoperative 3-dimensional MR cisternogram/angiogram fusion image clearly showed direct tumor compression of the trigeminal nerve and the absence of responsible vessels, which was useful for surgical planning. American Association of Neurological Surgeons 2022-08-29 /pmc/articles/PMC9426354/ /pubmed/36051778 http://dx.doi.org/10.3171/CASE22274 Text en © 2022 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ).
spellingShingle Case Lesson
Onoda, Keisuke
Ogasawara, Yoshifumi
Hirokawa, Yu
Sashida, Ryohei
Fujiwara, Ren
Wakamiya, Tomihiro
Michiwaki, Yuhei
Tanaka, Tatsuya
Shimoji, Kazuaki
Suehiro, Eiichi
Yamane, Fumitaka
Kawashima, Masatou
Matsuno, Akira
Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title_full Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title_fullStr Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title_full_unstemmed Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title_short Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
title_sort small vestibular schwannoma presented with trigeminal neuralgia: illustrative case
topic Case Lesson
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9426354/
https://www.ncbi.nlm.nih.gov/pubmed/36051778
http://dx.doi.org/10.3171/CASE22274
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