Preoperative clinico-radiological diagnosis of schwannoma arising from cavernous segment of abducens nerve

Moses, Justin; Vermani, Nittin; Bansal, Shonak

doi:10.4103/0028-3886.82743

Cited by 7 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To the best of our knowledge, only 34 cases have been reported in the literature to date. [1][2][3][4][5][6][7][8][11][12][13][14]17,19,[21][22][23][24][25][26][35][36][37][38] The role of radiosurgery has been documented in nonvestibular schwannomas with good results 10,16 ; however, its role in the treatment of AN schwannomas has not been well documented, with only 10 cases reported in literature (Table 2). 4,6,11,14,35 Sixth CN schwannomas are typically seen in the prepontine cistern, cavernous sinus, and orbit.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gamma Knife radiosurgery in the treatment of abducens nerve schwannomas: a retrospective study

Prasad¹,

Sharma²,

Kale³

et al. 2016

JNS

View full text Add to dashboard Cite

OBJECTIVE Of the intracranial schwannomas, those arising from the vestibular nerves are the most common. Abducens nerve (AN) schwannomas are very rare, and there is limited literature on their optimal management. Therapeutic options include surgery and/or stereotactic radiosurgery. The aim of this study was to evaluate the role of Gamma Knife radiosurgery (GKRS) in these sixth cranial nerve (CN) schwannomas. METHODS The authors performed a retrospective analysis of patients who had undergone GKRS for intracranial tumors at their institute in the period from 2003 to 2010. Inclusion criteria were as follows: isolated AN paresis on presentation, a lesion along the course of the sixth CN, and imaging features characteristic of a schwannoma. Patients with other CN deficits and neurofibromatosis Type 2 were excluded. Symptomatic improvement was defined as the resolution of or an improvement in diplopia noted on a subjective basis or as an improvement in lateral eyeball excursion noted objectively on follow-up. A reduction in tumor volume by at least 20%, as noted by comparing the pre- and post-GKRS images, was deemed significant. RESULTS Six patients with a mean age of 37.1 years (range 17-55 years) underwent primary GKRS. There were 2 prepontine cistern, 3 cavernous sinus, and 1 cisterno-cavernous tumor. The mean duration of symptoms was 6.1 months (range 3-12 months). The mean tumor volume was 3.3 cm (range 1.5-4.8 cm). The mean tumor margin radiation dose was 12.5 Gy (range 12-14 Gy), while the median margin dose was 12 Gy (50% isodose line). The median number of isocenters used was 5 (range 4-8). The brainstem received an average 8.35-Gy radiation dosage (range 5.5-11 Gy). The mean follow-up duration was 44.3 months (range 24-78 months). Symptoms remained stable in 1 patient, improved in 3, and resolved in 2 (total improvement 83%). Magnetic resonance imaging at the last follow-up showed a stable tumor size in 3 patients (50%) and a reduction in the other 3. Thus, the tumor control rate achieved was 100%. No new CN deficits were noted. CONCLUSIONS Abducens nerve schwannomas are rare intracranial tumors. They can be cavernous, cisternal, or cisterno-cavernous in location. Excellent tumor control rates and symptomatic improvement can be achieved with GKRS, which appears to be a safe and effective, minimally invasive modality for the treatment of such lesions. Therefore, it is reasonable to consider GKRS as the initial treatment of choice for this rare pathology. Long-term follow-up will be essential for further recommendations.

show abstract

Section: Discussionmentioning

confidence: 99%

“…4,6,11,14,35 Sixth CN schwannomas are typically seen in the prepontine cistern, cavernous sinus, and orbit. 13,22,37 They have an equal predilection for the prepontine and cavernous sinus locations but occur more frequently in females in the 4th to 5th decade of life. The most common presentation is horizontal diplopia.…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife radiosurgery in the treatment of abducens nerve schwannomas: a retrospective study

Prasad¹,

Sharma²,

Kale³

et al. 2016

JNS

View full text Add to dashboard Cite

show abstract

Radiosurgery in trochlear and abducens nerve schwannomas: case series and systematic review

et al. 2017

View full text Add to dashboard Cite

Our data suggest that first intention GKS is a safe and effective option for patients with small to medium size oculomotor schwannomas, providing a high rate of clinical alleviation and tumour control. When the initial tumour volume is too large for first intention GKS, a combined approach with planned subtotal resection followed by GKS can be performed, with favourable and comparable outcomes as in upfront GKS.

show abstract

Factors Associated with Abducens Nerve Recovery in Patients Undergoing Surgical Resection of Sixth Nerve Schwannoma: A Systematic Review and Case Illustration

et al. 2017

View full text Add to dashboard Cite

Preoperative clinico-radiological diagnosis of schwannoma arising from cavernous segment of abducens nerve

Cited by 7 publications

References 0 publications

Gamma Knife radiosurgery in the treatment of abducens nerve schwannomas: a retrospective study

Gamma Knife radiosurgery in the treatment of abducens nerve schwannomas: a retrospective study

Radiosurgery in trochlear and abducens nerve schwannomas: case series and systematic review

Factors Associated with Abducens Nerve Recovery in Patients Undergoing Surgical Resection of Sixth Nerve Schwannoma: A Systematic Review and Case Illustration

Contact Info

Product

Resources

About