Endoscopic assisted microneurosurgery for gasserian portion of trigeminal neuroma: two cases.
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We report two cases of trigeminal neuroma that were operated on by the neurosurgery team at Felicio Rocho Hospital, Belo Horizonte, Minas Gerais State, Brazil. Endoscopic assisted microsurgery was the technique used to approach the gasserian region tumor with good results. (+info)
Relation between corneal innervation with confocal microscopy and corneal sensitivity with noncontact esthesiometry in patients with dry eye.
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PURPOSE: An alteration in corneal innervation has been described in dry eye associated with diabetes mellitus, contact lens use, and LASIK. The purpose of this study was to evaluate whether dry eye not related to Sjogren's syndrome (NSDE) and dry eye related to primary Sjogren's syndrome (PSDE) are associated with an alteration of the corneal nerves and sensation. METHODS: Twenty-one patients with dry eye (10 NSDE and 11 PSDE) and 20 healthy volunteers were studied. Healthy volunteers were divided into two groups: one younger than 60 years (N<60) and the other 60 years of age or older (N> or =60). The study of the epithelium, stroma, and subbasal corneal nerves was performed with a confocal microscope. Mechanical, chemical, and thermal sensation was evaluated using the Belmonte noncontact esthesiometer. RESULTS: A statistically significant decrease in the number and density of subbasal nerves (P < 0.0001) and the density of superficial epithelial cells (P < 0.0001) was observed in dry eyes. The number and density of subbasal nerves was higher in the N<60 group. A significant decrease was found with respect to mechanical, chemical, and thermal sensitivity (P < 0.0001). Sensibility was better in the healthy eyes. A strong correlation was found between the density of superficial epithelial cells and the nerves and between the number and density of subbasal nerves and sensation (P < 0.001). CONCLUSIONS: The use of confocal microscopy and noncontact esthesiometry allow the detection of the presence of corneal neuropathy in patients with dry eye. (+info)
Trigeminal trophic syndrome: an unusual cause of a non-healing cheek ulcer.
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Trigeminal trophic syndrome (TTS) is an uncommon condition characterised by anaesthesia, paraesthesias and ala nasi ulceration, following peripheral or central damage to the trigeminal nerve. Only about 100 cases have been described in the literature to date. We report a 74-year-old woman who presented with a right cheek ulcer accompanied by pruritus and paraesthesia for three months. An old right cerebellar infarct was demonstrated on magnetic resonance imaging of the brain. Vertebrobasilar insufficiency leading to the cerebellar infarct is likely to have predisposed her to developing TTS. An underlying infectious, malignant and vasculitic cause for the ulcer was excluded by a skin biopsy. An increased awareness of the predisposing factors and clinical presentations of this important disfiguring condition is necessary to ensure prompt diagnosis and treatment. (+info)
An unusual presentation of adenoid cystic carcinoma of the minor salivary glands with cranial nerve palsy: a case study.
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BACKGROUND: Adenoid Cystic Carcinoma (ACC) is a rare tumor entity and comprises about 1% of all malignant tumor of the oral and maxillofacial region. It is slow growing but a highly invasive cancer with a high recurrence rate. Intracranial ACC is even more infrequent and could be primary or secondary occurring either by direct invasion, hematogenous spread, or perineural spread. We report the first case of the 5th and 6th nerve palsy due to cavernous sinus invasion by adenoid cystic carcinoma. CASE PRESENTATION: A 49-year-old African American female presented to the emergency room complaining of severe right-sided headache, photophobia, dizziness and nausea, with diplopia. The patient had a 14 year history migraine headaches, hypertension, and mild intermittent asthma. Physical examination revealed right lateral rectus muscle palsy with esotropia. There was numbness in all three divisions of the right trigeminal nerve. Motor and sensory examination of extremities was normal. An MRI of the brain/brain stem was obtained which showed a large mass in the clivus extending to involve the nasopharynx, pterygoid plate, sphenoid and right cavernous sinuses. Biopsy showed an ACC tumor with a cribriform pattern of the minor salivary glands. The patient underwent total gross surgical resection and radiation therapy. CONCLUSION: This is a case of ACC of the minor salivary glands with intracranial invasion. The patient had long history of headaches which changed in character during the past year, and symptoms of acute 5th and 6th cranial nerve involvement. Our unique case demonstrates direct invasion of cavernous sinus and could explain the 5th and 6th cranial nerve involvement as histopathology revealed no perineural invasion. (+info)
Dura-based giant intracranial schwannoma in the middle fossa.
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A 49-year-old female presented with a rare giant schwannoma arising from the dura mater of the middle fossa manifesting as loss of left visual acuity. Magnetic resonance imaging revealed a heterogeneously enhanced giant mass in the left middle fossa. Surgery via the transsylvian approach confirmed the origin of the tumor between the left internal carotid artery and the trigeminal nerve in the lateral wall of the cavernous sinus. Elongated abducens nerve was confirmed, but no tumor adhesion to the abducens nerve was found. The tumor was closely attached to the dura mater of the middle fossa and the lateral wall of the cavernous sinus. The histological diagnosis was schwannoma. Both left oculomotor and abducens nerve pareses occurred immediately after the operation but gradually resolved over 3 months. The operative findings indicated that this schwannoma may have arisen from the meningeal branch of the trigeminal nerve in the dura mater of the middle fossa. (+info)
Trigeminal sensory neuropathy and facial contact dermatitis due to Anthurium sp.
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BACKGROUND: Trigeminal sensory neuropathy (TSN) describes a heterogeneous group of disorders manifesting as facial numbness. OBJECTIVE: We report the case of a patient who had TSN associated with contact dermatitis due to Anthurium sp. METHOD/RESULTS: A 21-year-old female patient developed left hemifacial contact dermatitis after exposure to the anthurium plant. The patient had paresthesias and pain in the V2 and V3 divisions of the left trigeminal nerve. Eight days after its onset the dermatitis resolved, but numbness developed in the V2 and V3 divisions of the left trigeminal nerve. Cranial CT scan and MRI, as well as CSF and extensive work-up exams, were normal. After one month the symptoms disappeared completely. CONCLUSION: Anthurium sp, an indoor ornamental plant that contains calcium oxalate crystals, and can causes contact dermatitis. To our knowledge, this is the first report associating TSN with contact dermatitis due to Anthurium sp. (+info)
Atypical cystic meningioma of the trigeminal nerve in a pediatric patient.
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SUMMARY: We report an unusual case of atypical cystic meningioma of the trigeminal nerve proved by histology in a 15-year-old white girl. A review of the literature showed that this is only the second reported case of a meningioma of the trigeminal nerve without dural attachment and the first occurrence in a pediatric patient. (+info)
Perineural invasion through the maxillary division of the right trigeminal nerve in a rare case of nasolabial malignant peripheral nerve sheath tumor.
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SUMMARY: We report the CT and MR imaging findings in a patient with malignant peripheral nerve sheath tumor in the right nasolabial area, which exhibited typical imaging features of cystic adenoid carcinoma. (+info)