[Glossopharyngeal neurinoma causing symptomatic hemorrhage: case report].

A 86-year-old man was admitted to our hospital because of swallowing disturbance and deterioration of consciousness. He had been aware of hearing disturbance on the right side for twelve months. Computed tomography (CT) scan demonstrated an inhomogeneous hyperdense mass lesion, 3.2 X 2.3 cm in size, at the right cerebello-pontine angle, and ventricular enlargement with intraventricular hemorrhage. Skull tomogram revealed destructive enlargement of the right jugular foramen. The angiogram showed avascular mass with elevation of anterior inferior cerebellar artery, and downward shift of posterior inferior cerebellar artery. Operative and histological findings were compatible with glossopharyngeal neurinoma of Antoni type A dominance. This tumor had numerous abnormal vessels probably causing massive hemorrhage. Only fifteen cases of intracranial neurinoma with symptomatic hemorrhage have been reported in the world literature. This case is reported as the sixteenth one and the first glossopharyngeal neurinoma among them. Possible etiology of such hemorrhage is discussed.

[A variant of persistent trigeminal artery associated with a petroclival meningioma. Case report].

A 52-year-old female was admitted with a chief complaint of progressive gait disturbance over the previous 16 months. Neurological examination revealed impairment of the Vth and VIIIth cranial nerve functions and cerebellar ataxia on the left side. Computed tomography showed a petroclival tumor of 5 x 5 x 4.5 cm. Left carotid angiography disclosed tumor staining fed by branches of the tentorial artery. Also, an anomalous artery branched from the internal carotid artery between the C5 and C6 portions and supplied the region usually fed by the anterior inferior cerebellar artery. The tumor was removed via a combination of transpetrosal-transtentorial and transzygomatic approaches. The anomalous artery was confirmed to course along the Vth cranial nerve, replacing the anterior inferior cerebellar artery. Twenty-seven cases of variant persistent trigeminal artery have been reported in the world literature, including this case. The embryological and clinical features of this anomaly are discussed.

[Infantile optic glioma involving the whole optic pathway--a case report].

A case of infantile optic glioma involving the whole optic pathway is reported. The patient was a 4-month-old female. The mother noticed that the baby could not follow the object, although her physical development had been apparently normal only until three months after birth. On admission, she was lethargic, although no definite motor weakness was identified. The ophthalmological check revealed delayed bilateral pupillary light reaction and choked disks. Skull X-ray film showed the J-shaped sella and the enlarged bilateral optic canals. CT scan also revealed an isodensity mass in the suprasellar cistern and enlarged bilateral optic nerves. The lesions were enhanced homogeneously with contrast medium and extended toward both optic radiations. Lateral ventricles were mildly dilated. Cerebral angiography showed the upward shift of A1-portion of the bilateral anterior cerebral arteries and the backward shift of the basilar artery. No abnormal vessels were visible. A bifrontal craniotomy was performed to partially remove the suprasellar tumor. The histological diagnosis was optic glioma. The postoperative course was uneventful. The patient was discharged without any neurological deficits except poor visual acuity. Four months later, she suddenly fell into generalized convulsion. CT scan revealed the significant enlargement of residual tumor and ventricular dilatation. Surgical treatment of VP shunt was immediately performed on, and then irradiation of 4,000 rad of total dose to the tumor followed. The tumor size became definitively small. On a follow-up term of 15 months, the patient has been doing well.(ABSTRACT TRUNCATED AT 250 WORDS)