Background: Trigeminal neuralgia is defined by paroxysmal pain on the trigeminal nerve territory. The petroclival meningioma presents with trigeminal neuralgia in less than 5% of the cases. We report a case of a petroclival meningioma that encased the fifth nerve and was resected through a Kawase approach.
Clinical Presentation: A 67-year-old female patient presented paroxysmal shock pain in malar and ocular region with progressive worsening, evolving with daily crises despite the use of carbamazepine. On neurologic examination the patient was oriented, with no strength or coordination impairments. Cranial nerves exam showed left V1, V2, and V3 thermal and pain hypoesthesia, without allodynia. Normal strength in masticatory muscles was observed. Magnetic resonance imaging revealed a petroclival lesion with hypersign on T2 and contrast enhancement, suggestive of a meningioma. The tumor encased the trigeminal nerve at the entrance of the Meckel's cave. A temporal craniotomy with middle fossa peeling and anterior petrosectomy (Kawase approach) was performed and a Simpson II resection was achieved. The patient evolved with transient sixth nerve palsy, recovering completely after 3 months. During a follow-up of 5 years there was no evidence of tumor recurrence and the patient is free from pain without medication.
Conclusions: The Kawase approach is an interesting access for petroclival tumor resection.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2021.04.133 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Petroclival meningioma regression after combined oestrogen and nomegestrol acetate interruption.
BMJ Case Rep
January 2025
Neurosurgery, CHU de Liege Hospital Sart Tilman, Liege, Belgium
Meningioma regression after progestin treatment interruption is already established. Zoely is a combined oral contraceptive including oestradiol and progestin (nomegestrol acetate). The effect of combined oestrogen with nomegestrol acetate on meningioma is currently unknown.
View Article and Find Full Text PDFSemi-sitting position and retrosigmoid approach for a large petroclival meningioma resection: 3-dimensional operative video.
Surg Neurol Int
December 2024
Department of Neurosurgery, Padilla Hospital of Tucuman, San Miguel de Tucuman, Argentina.
Background: Petroclival meningiomas are still a neurosurgical challenge due to their proximity to cranial nerves and cerebral vasculature along the surgical corridor. The usual extension of large petroclival meningiomas is along the posterior fossa, frequently compromising and displacing adjunct cranial nerves such as the sixth and seventh-eight cranial nerve complex with brainstem compression, causing progressive neurological deficit and severe headache. The goal of sizeable petroclival meningioma surgery treatment is a maximal resection with preservation of neurological function.
View Article and Find Full Text PDFExternal Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study.
Oper Neurosurg (Hagerstown)
January 2025
Department of Neurosurgery, Yeditepe University School of Medicine, İstanbul, Türkiye.
Background And Objectives: The middle fossa approaches are tremendously versatile for treating small vestibular schwannomas, selected petroclival meningiomas, midbasilar trunk aneurysms, and lesions of the petrous bone. Our aim was to localize the internal acoustic canal and safely drill the petrous apex with these approaches. This study demonstrates a new method to locate the internal acoustic canal during surgery in the middle fossa.
View Article and Find Full Text PDFMiddle ear biofilm and sudden deafness - a light and transmission electron microscopy study.
Front Neurol
December 2024
Department of Surgical Sciences, Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
Background: There still exists controversy about whether the healthy human middle ear mucosa is sterile or if it may harbor a diverse microbiome. Considering the delicacy of the human round window membrane (RWM), different mechanisms may exist for avoiding inner ear pathogen invasion causing sensorineural deafness. We re-analyzed archival human RWMs using light and transmission electron microscopy after decalcification to determine if bacteria are present in clinically normal human middle ears.
View Article and Find Full Text PDFPediatric skull base tumors: Clinical features and surgical outcomes; a single center retrospective study with a review of literature.
Brain Spine
November 2024
Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
Article Synopsis
- Pediatric intracranial tumors at the skull base are rare, challenging to treat due to complex anatomy, and lack substantial clinical evidence, prompting a study on surgical approaches and outcomes.
- The study involved 12 children under 18 who underwent skull base surgery from 2017 to 2023, analyzing demographics, tumor details, surgical methods, and survival rates.
- Results indicated a predominance of female patients, varying tumor locations and types, with 58.3% achieving gross or near-total resection; however, 33.3% of patients died from tumor progression within an average of 15 months.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!