ABSTRACT
Numbness of the lower lip, the skin of the chin, or the gingiva of the lower anterior teeth secondary to various dental diseases is a common manifestation that is largely underappreciated. The association of numb chin syndrome (NCS) with serious disease like metastatic malignancy and systemic conditions is frequent enough to warrant a search for these possible etiologies. In this paper we report a case of NCS that occurred secondary to malignant disease; we discuss our findings with special emphasis on metastatic malignancies leading to NCS, when the survival is only for a few months.
Subject(s)
Chin/innervation , Cranial Nerve Neoplasms/complications , Humans , Hypesthesia/etiology , Lymphoma, Non-Hodgkin/complications , Male , Mandibular Neoplasms/complications , Mandibular Neoplasms/secondary , Mandibular Nerve , Middle Aged , SyndromeABSTRACT
A 51-year-old woman with breast cancer presented with progressive diplopia. Neuro-ophthalmologic examination revealed right gaze palsy and peripheral facial nerve palsy. Brain magnetic resonance imaging (MRI) was normal. However, two months later a repeat brain MRI revealed an enhancing round nodular mass at the right facial colliculus of the lower pons, at the location of the abducens nucleus. Localized metastasis to the abducens nucleus can cause gaze palsy in a patient with breast cancer.
Subject(s)
Female , Humans , Middle Aged , Abducens Nerve Diseases , Breast Neoplasms/pathology , Cranial Nerve Neoplasms/complications , Facial Paralysis/complications , Fixation, Ocular , Magnetic Resonance Imaging , Ocular Motility Disorders/etiology , Pons/pathologySubject(s)
Female , Humans , Middle Aged , Cranial Nerve Neoplasms/complications , Glossopharyngeal Nerve Diseases/complications , Neurilemmoma/complications , Vocal Cord Paralysis/etiology , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/surgery , Glossopharyngeal Nerve Diseases/diagnosis , Glossopharyngeal Nerve Diseases/surgery , Neurilemmoma/diagnosis , Neurilemmoma/surgery , Treatment Outcome , Vocal Cord Paralysis/diagnosis , Vocal Cord Paralysis/surgeryABSTRACT
O implante auditivo de tronco cerebral foi desenvolvido para restaurar alguma audição útil em pacientes que apresentam ausência de nervo coclear bilateralmente. OBJETIVOS: Discutir a indicação, cirurgia e resultados em quatro pacientes submetidos à cirurgia para colocação de implante auditivo de tronco cerebral. CASUÍSTICA E MÉTODOS: Quatro pacientes com diagnóstico de schwannomas vestibulares bilaterais foram submetidos à cirurgia para colocação de Implante Auditivo de Tronco Cerebral durante o mesmo ato cirúrgico utilizado para a exérese de um dos tumores. Aspectos clínicos e técnicos e as referências anatômicas da cirurgia e os resultados auditivos foram analisados. RESULTADOS: Em todos os casos foram identificados as referências anatômicas ao forame de Luschka. As complicações cirúrgicas se resumiram à fístula liquórica em dois pacientes. Os eletrodos foram bem posicionados e a sensação auditiva foi suficiente para reconhecimento de sons e auxílio à leitura labial. CONCLUSÃO: Os resultados auditivos de nossos pacientes abrem uma perspectiva importante aos pacientes com surdez profunda bilateral sem integridade anatômica das vias auditivas centrais.
Auditory Brainstem Implants were developed to partially restore the hearing capabilities of patients without cochlear nerves bilaterally. AIM: this paper aims to discuss the clinical and surgical findings of four ABI patients. MATERIALS AND METHOD: four patients diagnosed with bilateral schwannomas received auditory brainstem implants (ABI) and had one of their tumors resected in the same surgical procedure. Clinical aspects, surgical technique, anatomic landmarks, and outcomes were analyzed. RESULTS: the anatomic landmarks were identified in all four patients in relation to the foramina of Luschka. Two patients had CSF leaks. The electrodes were well positioned and hearing sensation was good enough to allow for sound recognition and assist patients perform lip reading. CONCLUSION: the outcomes observed in our patients were quite encouraging and offer great perspectives for those suffering from deep bilateral deafness and impaired central auditory pathways.
Subject(s)
Adult , Female , Humans , Male , Auditory Brain Stem Implants , Cranial Nerve Neoplasms/surgery , /surgery , Cerebrospinal Fluid Rhinorrhea/etiology , Cranial Nerve Neoplasms/complications , Electric Stimulation , Hearing Tests , Magnetic Resonance Imaging , /complicationsABSTRACT
Apresentamos um caso de neuralgia do trigêmeo com investigação radiológica de ressonância magnética (RM) e tomografia computadorizada apresentando resultado normal. A dor não apresentou alívio com carbamazepina, sendo indicado descompressão microvascular do trigêmio. Passados dois meses, o paciente queixava-se de dor com intensidade similar à do pré-operatório. Nova RM mostrou lesão expansiva no cavo de Meckel, a qual foi tratada cirurgicamente por abordagem extra-dural. O exame anatomopatológico foi compatível com melanoma primário. O seguimento radiológico, após seis meses da cirurgia, não apresentou anormalidades.
Subject(s)
Humans , Male , Middle Aged , Cranial Nerve Neoplasms/complications , Melanoma/complications , Trigeminal Neuralgia/etiology , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/therapy , Decompression, Surgical , Magnetic Resonance Imaging , Melanoma/diagnosis , Melanoma/therapy , Tomography, X-Ray Computed , Trigeminal Neuralgia/therapyABSTRACT
A 15 year old male, who had earlier been operated for intraspinal intramedullary ependymoma, subsequently developed a right cerebello pontine (CP) angle mass. A diagnosis of right CP angle ependymoma was considered, in view of established histology of previously operated spinal lesion. Histopathological examination of the well defined extra-axial mass, which was attached with ninth cranial nerve, however revealed a schwannoma. A diagnosis of Neurofibromatosis-2 (NF2) is strongly suspected, because of well established fact, that the spinal ependymomas may have association with lower cranial nerve schwannomas in NF2. Cranial and spinal MRI screening for early diagnosis of associated, asymptomatic lesions, in suspected cases of NF2, particularly in children, is recommended.
Subject(s)
Adolescent , Cranial Nerve Neoplasms/complications , Ependymoma/complications , Humans , Male , Neurilemmoma/complications , Neurofibromatosis 2/complications , Spinal Cord Neoplasms/complicationsABSTRACT
Neste trabalho são estudados 50 pacientes portadores de NAC submetidos a tratamento cirúrgico para remoção do tumor. Estabelece-se correlação estatística entre a preservação da função motora da NFAC e achados clínicos, de neuroimagem e intra-operatórios. O objetivo é determinar quais fatores podem exercer influência significativa do ponto de vista estatístico no prognóstico da função motora do NFAC no seguimento pós-operatório, além de estabelecer a melhor época para reinvenção da musculatura da mímica facial, quando necessária. Os resultados mostraram que a probabilidade de preservação funcional do NFAC é influenciada conjuntamente pelo tamanho do tumor e pela idade do paciente. Portanto pacientes idosos e portadores de tumores volumosos apresentam menor probabilidade de preservação de função motora adequada do NFAC, definida neste trabalho como graus I e III na escala de House. A aderência tumora ao tronco encefálico, com maior probabilidade de ocorrer nos tumores volumosos e irregulares, também mostrou associação com a dificuldade de preservação funcional do NFAC.
Subject(s)
Humans , Cranial Nerve Neoplasms/surgery , Cranial Nerve Neoplasms/complications , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/pathology , Cranial Nerve Neoplasms/therapy , Facial Nerve/surgery , Neurilemmoma/surgery , Neurilemmoma/diagnosis , Neurilemmoma/therapy , Cerebellopontine Angle , Cochlear Nerve , Hearing Loss/surgery , Hearing Loss/complications , Hearing Loss/diagnosis , Radiosurgery/history , Tomography/methodsSubject(s)
Adult , Middle Aged , Humans , Male , Female , History, 20th Century , Cranial Nerve Neoplasms , Cochlear Nerve/pathology , Trigeminal Neuralgia/etiology , Neurilemmoma , Cranial Nerve Neoplasms/complications , Cranial Nerve Neoplasms/diagnosis , Cranial Nerve Neoplasms/surgery , Facial Paralysis , Neurilemmoma/diagnosis , Neurilemmoma/surgeryABSTRACT
The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been described in a wide range of neurological and other disorders. We wish to add an extremely rare case of a solitary, large invasive neurofibroma of the sixth cranial nerve extensuvely destroying the sella turcica in the skull base and causing inappropriate secretion of antidiuretic hormone in a 44-year-old black man in the absence of neurofibromatosis.