Spinal Schwannoma; Analysis of 40 Cases

OBJECTIVE: This study is to report our experience of 40 cases of spinal schwannoma. METHODS: From 1995 to 2006, medical records were retrospectively reviewed in 40 cases of spinal schwannoma. RESULTS:We treated 40 spinal schwannomas in 38 (22 male and 16 female) patients. The mean age was 50.2. Four cases were sited in the cervical spine, 11 cases in the thoracic spine, and 25 cases in the lumbar spine. Two patients showed recurrences. Thirty-eight cases were intradural-extramedullary type and 2 cases were extradural. Two cases (5%) including 1 recurred case had no postoperative motor improvement. Ninety-five percents of patients improved on postoperative motor grade. CONCLUSION: Spinal schwannoma is mostly benign and extramedullary tumor. There were 2 recurred cases (5%) that had history of previous subtotal removal at first operation and had shown worse prognosis compared with the cases without recurrence. To reduce the recurrence of spinal schannoma, total excision of tumor mass should be done.

Bilateral Cortical Blindness Caused by Tentorial Herniation due to Brain Tumor

Two patients, one with glioblastoma multiforme (GM) in the right thalamus and the other with meningioma at the right frontal convexity, had suffered bilateral cortical blindness after transtentorial herniation. On one of those patients, bilateral cortical blindness had occurred due to acute obstructive hydrocephalus caused by GM and on the other patient, cortical blindness had developed after acute hemorrhage from meningioma. Bilateral occipital lobes of those patients showed signal change on the brain magnetic resonance image (MRI). There were no ophthalmologic abnormalities on fundoscopy and ophthalmologic examination. After recovery of consciousness, cortical blindness was detected in both patients, and during gradual recovery period, visual function was slowly recovered. The pattern of visual evoked potential (VEP) at 7 weeks and 12 weeks after herniation was normalized gradually. Cortical blindness due to herniation was reversible, even though the high signals of bilateral visual cortex still existed on MRI 16 months later in case 2.