ABSTRACT
We present a 38-year-old female with a giant dumbbell-shaped trigeminal neurinoma originating primarily in the middle cranial fossa, extending to the infratemporal and posterior fossae through the foramen ovale and Meckel's cave, respectively. Because of the large tumour extension into the Infratemporal Fossa, a combined skull base approach (zygomatic infratemporal - transmandibular) was utilised for tumour removal, with a subsequent excellent outcome. An extensive literature review since 1935, revealed 580 cases of surgically treated trigeminal neurinomas. Among these, only three were located in three distinct compartments, making this the rarest developmental pattern for trigeminal neurinomas.
Subject(s)
Cranial Nerve Neoplasms/diagnosis , Magnetic Resonance Imaging , Neurilemmoma/diagnosis , Neurosurgical Procedures , Trigeminal Nerve Diseases/diagnosis , Adult , Cranial Fossa, Middle , Cranial Fossa, Posterior/pathology , Cranial Nerve Neoplasms/surgery , Female , Humans , Neoplasm Invasiveness , Neurilemmoma/surgery , Neurosurgical Procedures/methods , Skull Base/surgery , Trigeminal Nerve Diseases/surgeryABSTRACT
We present the case of a young male with severe head injury, cervico-thoracic fractures, and an initially unrecognized brainstem infarct due to unilateral dissection of vertebral artery, who made an unusually excellent recovery. This report stresses the importance of prompt clinico-imaging diagnosis and prophylactic anticoagulant treatment in such cases.
