Cystic Dumbbell-Shaped C1 Schwannoma with Intracranial Extension and Hydrocephalus

Matsui, Yusuke; Fukumura, Mariko; Toda, Masahiro

doi:10.1016/j.wneu.2020.12.173

Cited by 3 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As reported by Jiang et al [ 11 ] in their 6 cases, occipito-cervical fusion may be performed after CVJ schwannoma resection with C1–C2 facetectomy or occipital condylotomy to prevent spine instability, but higher risks of CSF leaks were noted. Intraoperatively, if nerve rootlets were embedded within tumors and not accurately detachable, nerves were often sacrificed to achieve GTR [ 64 , 65 ]. In these cases, patients experienced minimal or no neurological sequelae, likely because the presence of pre-operative deficits caused gradual compensation from adjacent neural structures and loss-of-function of the involved nerves [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Palmisciano

Ferini²,

Watanabe

et al. 2022

Current Oncology

View full text Add to dashboard Cite

Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Palmisciano

Ferini²,

Watanabe

et al. 2022

Current Oncology

View full text Add to dashboard Cite

show abstract

“…1 Dumbbell-shaped schwannomas are rare and can present with either brainstem or upper cervical cord compression features or with vascular insufficiency due to vertebral artery compression. [2][3][4] Resection remains challenging owing to the proximity of critical neurovascular structures, high tumor vascularity, and extraspinal tumor extensions. 2,3,5,6 Depending on tumor extension (dorsal or ventral), either a traditional posterior approach 6 or an anterolateral approach may be chosen.…”

mentioning

confidence: 99%

“…[2][3][4] Resection remains challenging owing to the proximity of critical neurovascular structures, high tumor vascularity, and extraspinal tumor extensions. 2,3,5,6 Depending on tumor extension (dorsal or ventral), either a traditional posterior approach 6 or an anterolateral approach may be chosen. 7 Our patient presented with complaints of suboccipital headache and progressive spastic quadriparesis for 1 year.…”

mentioning

confidence: 99%

Microsurgical Removal of Dumbbell-Shaped C1 Schwannoma: Utility of Subcapsular Dissection to Safeguard Critical Neurovascular Structures: 2-Dimensional Operative Video

Das,

Singh,

Rai

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

Schwannomas in the craniocervical junction usually arise from lower cranial nerves or 1st and 2nd cervical nerves. 1 Dumbbell-shaped schwannomas are rare and can present with either brainstem or upper cervical cord compression features or with vascular insufficiency due to vertebral artery compression. [2][3][4] Resection remains challenging owing to the proximity of critical neurovascular structures, high tumor vascularity, and extraspinal tumor extensions. 2,3,5,6 Depending on tumor extension (dorsal or ventral), either a traditional posterior approach 6 or an anterolateral approach may be chosen. 7 Our patient presented with complaints of suboccipital headache and progressive spastic quadriparesis for 1 year. His magnetic resonance imaging revealed a 5.5 × 2.4 × 2.3 cm homogenously contrast-enhancing lesion with an area of central necrosis at the craniovertebral junction. The ipsilateral vertebral artery was poorly visualized with possible tumor feeders from the ipsilateral occipital artery. The patient consented to the procedure and to the publication of his image. Intraoperatively, careful resection of the intradural part was then followed by removing the extradural part. The vertebral artery was adherent to the tumor's posterior capsule, which was preserved using fine microsurgical dissection. The patient recovered well from surgery. In this video, we have highlighted the importance of subcapsular dissection in the preservation of surrounding nerves, vessels, and brainstem and "inside out" subcapsular resection of the extraspinal part using a standard midline posterior approach. The importance of preoperative radiological workup is extremely important in such cases to know the course of the vertebral artery in relation to the tumor.

show abstract

Far lateral approach for dumbbell-shaped C1 schwannomas: how I do it

Xu,

Wang,

et al. 2024

Acta Neurochir

View full text Add to dashboard Cite

Cystic Dumbbell-Shaped C1 Schwannoma with Intracranial Extension and Hydrocephalus

Cited by 3 publications

References 8 publications

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review

Microsurgical Removal of Dumbbell-Shaped C1 Schwannoma: Utility of Subcapsular Dissection to Safeguard Critical Neurovascular Structures: 2-Dimensional Operative Video

Far lateral approach for dumbbell-shaped C1 schwannomas: how I do it

Contact Info

Product

Resources

About