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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although schwannoma may arise from any true cranial nerve, it is well known that the acoustic and trigeminal nerves are frequent origins. Schwannomas of the facial nerve are rare. In this communication, two cases of facial nerve schwannoma arose from the horizontal portion are reported. Case 1. A 44 year-old male was admitted to our clinic complaining of left hearing loss and facial asymmetry. About three years prior to the admission, he first noticed left hearing disturbance which was gradually deteriorated and was transiently accompanied by left tinnitus during the progression. Then muscle spasm developed on the left eyelid which resolved spontaneously in a few weeks, then asymmetry of the face developed. Neurological examination on admission revealed left hearing loss and left peripheral facial palsy. As a result of neuro-otological examinations, left hearing impairment and left facial palsy were thought to be due to retrocochlear and suprageniculate lesions respectively. Plain skull radiograms and tomograms revealed marked destruction of left pyramis and enlarged internal auditory canal. Computed tomography of the brain showed low-density mass in the left middle fossa and defect of the tip of the left pyramis. After bolus injection of contrast material, peripheral portion of the middle fossa mass was enhanced non-homogeneously and enhanced mass extended to the posterior fossa. Left middle and posterior fossas were explored by carrying out a osteoplastic temporal flap and suboccipital craniectomy. A large extradural mass was noted to have filled the middle fossa which extended to the posterior fossa through destroyed pyramis and enlarged internal auditory canal. The tumor was removed subtotally.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Facial nerve schwannomas: report of two cases]. 646 66

The syndrome of tic convulsif consists of ipsilateral concurrent trigeminal neuralgia and hemifacial spasm. Since Cushing's 1920 description of this syndrome in three patients, 37 additional cases have been reported in the world literature. Of the 15 with adequate operative descriptions, 10 had vascular abnormalities and five had tumors. The authors report 11 cases of tic convulsif treated by microvascular decompression of both the fifth and seventh cranial nerves. At operation, 21 of 22 nerves were found to have root entry zone vascular compression. One trigeminal nerve was considered normal. One seventh nerve had a tumor displacing the anterior inferior cerebellar artery into its root entry zone. The average follow-up period in this series was 6 years 2 months (range 1 to 8 1/2 years). Eight patients (73%) were pain-free, two (18%) had frank recurrences, and one (9%) had mild discomfort. Eight patients (73%) were totally free of facial spasm, and two others (18%) had only a trace of residual spasm. These results are comparable to those achieved by treating the individual syndromes with microvascular decompression. Therefore, microvascular decompression of both the fifth and seventh cranial nerves is recommended as the treatment of choice in tic convulsif.
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PMID:Tic convulsif: results in 11 cases treated with microvascular decompression of the fifth and seventh cranial nerves. 649 38

The authors report a case of neurovascular compression of the eighth cranial nerve in a 49-year-old businessman. The patient was admitted to the University of Tokyo Hospital because of progressive vertigo and tinnitus on the right without hearing loss over the seven years prior. There were no other symptoms. The general examination was normal. He was neurologically intact except for loss of caloric response. Audiometric studies and brain stem response were normal. The findings of routine hematology, biochemistry, and serology were within normal limits. Tomogram showed that right internal auditory meatus was wider than the left by 2 mm. Computed tomography with metrizamide demonstrated a filling defect in the right cerebellopontine angle. We decided to proceed with exploratory operation with the tentative diagnosis of a left cerebello-pontine angle mass, perhaps neurinoma en plaque meningioma, or epidermoid tumor. Left retromastoid craniectomy with microsurgical exploration of the cerebellopontine angle revealed not a tumor, but a loop of the anterior interior cerebellar artery (AICA) compressing the eighth cranial nerve close to the porus acousticus. A piece of muscle was inserted between the eighth cranial nerve and the AICA. His postoperative course was uneventfull with complete relief of symptoms and without impairment of hearing. In patients with hemifacial spasm and trigeminal neuralgia, neurovascular compression (NVC) has been found at the root entry zone of the facial or trigeminal nerves close to the brain stem at the "junction zone" on the glia and schwann sheath of these nerves.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Case of tinnitus, vertigo, and a loss of caloric response due to neurovascular compression]. 660 57

Endoscopic sphincterotomy (papillotomy) was performed in 289 patients for choledocholithiasis (250, of whom 223 had undergone cholecystectomy previously), papillary stenosis or spasm (32) and ampullary neoplasm (7). The complications encountered in 39 patients were hemorrhage (15 patients), perforation (4), hemorrhage and perforation (1), cholangitis (5), pancreatitis (11), impaction (1) and others (2). Laparotomy was required in seven of these patients for hemorrhage (two), perforation (two), hemorrhage and perforation (one), pancreatitis (one) and impaction (one). Bleeding required duodenotomy with an extension of the sphincterotomy incision to control hemorrhage, and a formal sutured sphincteroplasty. Perforation occurred at the junction of the distal bile duct and duodenum and was managed by mobilization of the duodenum, with T-tube drainage through the perforation, and sutured closure. A pancreatic abscess following pancreatitis required surgical drainage. An impacted Dormia basket with entrapped stone in the bile duct required duodenotomy for its removal. There was a high risk of perforation in those patients who did not have choledocholithiasis or who had had a previous Billroth II gastrectomy. There were two deaths but the overall complication rate of 2.4% is considered low, because many of the patients were elderly or debilitated.
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PMID:Surgical complications of endoscopic sphincterotomy. 672 68

Radiographic findings in 68 patients with trigeminal neuralgia and 24 patients with hemifacial spasm are reviewed. The relative value of various radiographic diagnostic procedures is discussed. Trigeminal neuralgia and hemifacial spasm are usually caused by vascular compression of the trigeminal root entry zone and facial nerve exit zone respectively. Computed tomography (CT) of the posterior fossa is the only radiographic screening procedure required. Angiography should be reserved for patients in whom CT findings suggest an aneurysm or tumor.
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PMID:Radiography of trigeminal neuralgia and hemifacial spasm. 677 3

A 49-year-old man with an epidermoid tumor had a hemifacial spasm on the left and ipsilateral trigeminal neuralgia--i.e., painful tic convulsif. Computed tomography scanning after metrizamide enhancement clearly demonstrated a cerebellopontine angle tumor. In the year since complete removal of the epidermoid tumor, the patient has been relieved of the facial pain and the hemifacial spasm is improved with decreased frequency of the spasm.
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PMID:Epidermoid tumor presenting as painful tic convulsif. 683 75

In hemifacial spasm a late abnormal motor response was elicited by the antidromic volley after stimulating a peripheral branch of the facial nerve. The site of the lesion was calculated from the latency of that motor response and the conduction velocity. In 5 patients the distance was long, and corresponded with a tumor or a vascular anomaly at the cerebellopontine region in 3 of them. An artery sling entering the internal acoustic meatus was found in 2 out of 3 patients with short distances. It is concluded that hemifacial spasm results from a nerve lesion that may be located as far peripherally as the internal acoustic meatus. The theory of facial nuclear irritation is incompatible with such a peripheral lesion.
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PMID:Hemifacial spasm: location of the lesion by electrophysiological means. 698 79

The anatomy and location of the cervical spine make it vulnerable to injury and to the cumulative effects of chronic stress and strain. Tumors (local and metastatic), arthritis, and metabolic disorders also take their toll. Trauma from accidents may not be apparent immediately, and only some time later an unusual neck motion unexpectedly precipitates pain and muscle spasm.
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PMID:Cervical trauma: not just another pain in the neck. 706 Sep 45

Hemifacial spasm is a syndrome of intermittent and tonic unilateral facial muscular contraction; mild facial weakness on the same side is also frequently present. Hemifacial spasm can be differentiated clinically from habit spasms, blepharospasm, facial synkinesis following Bell's palsy, facial myokymia, and masticatory spasm. The syndrome of hemifacial spasm is caused by a variety of lesions; the common feature appears to be compression of the facial nerve at the pons. Diagnostic studies do not usually add significant information to that gained from the history and physical examination. The best current treatment (aside from removing an etiologic lesion such as a posterior fossa tumor in the small percentage of cases with such lesions) is microvascular decompression of the facial nerve at the pons through a retromastoid craniectomy. Of 30 patients treated in this manner, 28 have been satisfied with the results. On the most recent follow-up examination, 16 had no hemifacial spasm, nine had only slight periodic twitching about the eye, and three had occasional mild episodes of hemifacial spasm.
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PMID:Hemifacial spasm: treatment by microvascular decompression of the facial nerve at the pons. 731 39

A case of hemifacial spasm associated with a cerebellopontine angle lipoma is described. Both the seventh and the eighth cranial nerves were incorporated and distorted within this tumor, which seemed to be the cause of hemifacial spasm and other cranial nerve dysfunctions, but obvious vascular elements were not included. To identify a cerebellopontine angle lesion as a lipoma is very important in surgical management. Magnetic resonance imaging is essential to the differential diagnosis of the cerebellopontine angle lesion.
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PMID:Hemifacial spasm resulting from cerebellopontine angle lipoma: case report. 759 19


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