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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a retrospective study conducted on 40 patients with neurinoma of the cauda equina, assessing the clinical features and treatment. Neurinomas are clinically indistinguishable from other tumours localized in the same region. It is possible, but not simple, to differentiate neurinoma of the cauda equina from more common lumbar disc herniations. In the early stage, neurinomas provoke sciatic pain that is unilateral and monoradicular, worsened in decubitus and hard to define, whereas in the later stage pain becomes bilateral, polyradicular and is mostly accompanied by motor and sensory disturbances. Moreover, Lasegue's sign was often absent. Therapeutically, total removal of the tumour seems to be the most appropriate form of treatment given that even the sacrifice of a root does not worsen any pre-existing neurological deficit.
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PMID:Neurinomas of the cauda equina clinical analysis of 40 surgical cases. 794 3

Over a 22-year period, operations were performed on 263 patients for 288 primary benign tumors of major peripheral nerves. The tumors included 85 schwannomas, 197 neurofibromas, and six plexiform neurofibromas. Total removal was achieved in 83 of the 85 schwannomas, and 76 of these patients were available for follow-up evaluation. Motor function either improved or was unchanged in 87% of these patients and 85% of those with pain in the distribution of the involved nerve had either total or partial resolution of their symptoms. Of the neurofibromas, 123 occurred in 121 patients without von Recklinghausen's disease. All tumors within this group were completely excised using a fascicular approach to the tumor. Of the 99 patients available for follow-up evaluation, 90% had either improved or unchanged motor function and 88% had partial or complete resolution of pain syndromes. Fifty-nine patients with von Recklinghausen's disease had 80 tumors removed: 74 fusiform tumors (58 of which were completely removed) and six plexiform tumors. Forty-eight of the 58 patients with gross total removal of fusiform tumors were available for follow-up evaluation, of whom 83% had improved or unchanged motor function and 74% had partial or complete resolution of pain syndromes. All six patients with plexiform tumors had progression of symptoms postoperatively. One brachial plexus schwannoma recurred and was re-excised without subsequent recurrence at the 5-year follow-up evaluation. Several incompletely excised plexiform neurofibromas have recurred with a symptomatic presentation.
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PMID:Neural sheath tumors of major nerves. 805 43

Since 1985 147 explorations of the cerebellopontine angle have been performed in patients with trigeminal neuralgia (TN), in 26 patients with hemifacial spasm (HFS), and in the craniospinal region in 22 patients with spasmodic torticollis (ST). In TN in 128 (87%) patients vascular compression of the fifth nerve was found, in 8 (5%)--compression by a tumour, but in 11 (7.5%) nerve compression was not observed. In 92 (63%) patients only microvascular decompression (MVD) was performed, but in 36 (24.5%)--MVD and partial sensory rhyzotomy (PSR). Following MVD pain was absent or insignificant in 121 (92%) after MVD and PSR in all 36 patients, recurrence was observed in 5 (5%) cases. MVD was inefficient in case of atypical TN. Two patients died. As diagnostic criteria for vascular decompression pre-operative and intra-operative recording of short latency somatosensory evoked potentials of the fifth nerve were used. In all HFS patients vascular compression of the facial nerve roots has been established. Following MVD spasm was absent in 18 (69%) patients, 6 (23%) patients had significant improvement, but in two cases (8%) the improvement was insignificant. During craniospinal exploration in ST the accessory nerve was compressed in 6 cases by artery, in 6 patients only by cross-sectional adhesions, in two by a hypertrophied dentate ligament and in 3 cases by small neurinomas of the XI th nerve. Following microdecompression of the accessory nerve (without roots transsection) 17 (77%) patients fully recovered or had significant improvement. One of the 4 patients with insignificant improvement had previously undergone stereotactic surgery, but the other had retrocollis. In one patient with neurinoma of the XI nerve recurrence was observed, no significant improvement was noted in the other two patients.
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PMID:Microneural decompression operations in the treatment of some forms of cranial rhizopathy. 812 59

During the last seven years (1985-91) 28 primary tumours in the cauda among 104 intraspinal tumors were observed. The largest group (71%) comprised ependymomas and neurinomas. The rest included 5 lipomas, 2 astrocytomas and 1 epidermoid. Low-back pain without or with sciatic or crural irradiation was the most common initial symptom. The length of symptomatology is generally measured in months, because pain is erroneously referred to discal pathology for long time. The X-ray standard test and the CT scan have been of modest utility in the diagnosis of these lesions, but however they have been necessary for diagnostic screening. The MNR, a bloodness test, showed an important diagnostic value for the identification of these tumors; it is also useful in follow-up to exclude recurrence. The lipoma's and ependymoma's surgery, although performed by microsurgical techniques, showed great problems. Total removal of the ependymomas assured no recurrence at the follow-up. Sphincter disturbances were frequent after the operation, but they disappeared after some months. In most patients with lipomas the resection was partial, but at follow-up they were symptomless. Neurinomas' surgery presented less technical difficulties and the postoperative course was more favorable. Astrocytomas underwent to radiotherapy but their prognosis is not favorable.
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PMID:Primary cauda equina tumors. 812 80

Neurilemoma (schwannoma) is the most commonly encountered nerve sheath tumor of the oral cavity. It generally appears as a single encapsulated nodule that occasionally causes pain or discomfort. The tongue is involved most frequently, followed by the palate, floor of mouth, and buccal mucosa. Neurilemomas occur most often during the second or third decades of life. Our patient is a 21-year-old woman with a recurrence of a palatal mass that was excised 3 years earlier. Histologically the lesion appeared to be a multinodular neurilemoma, a pattern rarely reported in the oral cavity.
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PMID:Multinodular versus plexiform neurilemoma of the hard palate. Report of a case. 813 33

The authors reports a case of malignant schwannoma of sciatic nerve. Clinically, this tumor was manifested by a progressive tumefaction of the leg, and moderate pain, without functional signs. The origin of the sciatic nerve has been suspected by computed tomography, because its location, the vascular contacts, and the lesion's extension. Biopsy leads to confirm the nerve tumor, and precised the histologic type: malignant schwannoma. Local, regional and general extension did not premise treatment.
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PMID:[Extensive malignant schwannoma of the sciatic nerve. Contribution of imaging techniques]. 815 27

After more than a year of persistent lumbosacral pain a 53-year-old woman suddenly developed unilateral monoradicular pain over the S1 dermatome. Neurological, general medical and biochemical examinations were unremarkable, but myelography and magnetic resonance imaging revealed a cystic intraspinal space-occupying lesion at the level of L1, which was completely excised surgically. It proved to be a neurinoma, 5 x 3 x 3 cm, completely filling the spinal canal at the junction between the conus medullaris and the cauda equinus. The patient was without symptoms and neurological deficit after the operation. The tumour having been completely removed, the prognosis is good.
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PMID:[Intraspinal neurinoma in the thoracolumbar junction presenting unusual symptoms. The differential diagnosis of lumbago]. 816 24

The authors report a rare case of a large cystic cervical neurinoma. A 45-year-old female was admitted to our clinic because of motor weakness of the right upper extremity, numbness of the right fingers and right posterior cervical pain. Metrizamide CT myelography demonstrated the outline of a low density mass. MRI showed a mass revealing low signal intensity on T1-weighted image, high signal intensity on T2-weighted image and marginal enhancement on contrast image with Gd-DTPA. The mass which was diagnosed as cystic tumor, was located in the intradural extramedullary space between C4 to C5 segments. After C4 through C5 laminectomy, the tumor was found to originate from the C5 anterior motor root. The tumor consisted mostly of a cystic part with a very thin solid compartment beneath the capsule. Postoperative course of the patient was uneventful. Although spinal neurinoma is one of the most common spinal tumors, an almost completely degenerated large cystic spinal neurinoma is extremely rare. MRI with Gd-DTPA was useful for the diagnosis of the cystic neurinoma by clearly enhancing the margin of the tumor.
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PMID:[A case of macrocystic cervical neurinoma diagnosed by MRI with Gd-DTPA]. 825 27

Facial pain is a common complaint that leads those who have it to seek professional help. Often times, the general dentist is the first clinician that a patient consults because of a presumed odontogenic origin of the pain. Occasionally a small number of these patients will be found to have an intracranial tumor. The case reported here is one such patient who was diagnosed and treated for a seventh nerve schwannoma.
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PMID:Intracranial schwannoma as atypical facial pain. Case report. 836 22

48 dumbbell like neurinoma at upper cervical vertebra were totally removed operatively and confirmed pathologically. Intermittent pain at neck and occiput limitation of neck movement, and numbness or pain at one or both side limbs were the most common symptoms. In the early stage, the disease was difficalt to recognize. If X-ray film of the cervical vertebra at bioblique position showed an enlarged intervertebral foramen, the diagnosis of neurinoma should be highly considered. MRI could make a definite diagnosis. Vertebral artery angiography is of great value. We also introduced experience in how to protect vertebral artery and respiratory function during operation.
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PMID:[Dumbbell like neurinoma at upper cervical vertebra: report of 48 cases]. 858 24


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