J Neurol Surg Rep 2015; 76(02): e248-e252
DOI: 10.1055/s-0035-1564059
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Trochlear Nerve Schwannoma Treated with Gamma Knife after Excision: A Case Report and Review of the Literature

Takuro Inoue
1   Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan
,
Ayako Shima
1   Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan
,
Hisao Hirai
1   Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan
,
Fumio Suzuki
1   Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan
,
Masayuki Matsuda
1   Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan
› Author Affiliations
Further Information

Publication History

27 March 2015

17 July 2015

Publication Date:
09 September 2015 (online)

Abstract

Trochlear nerve schwannomas are extremely rare. We present a surgically excised case of trochlear nerve schwannoma followed by Gamma Knife (ELEKTA, Stockholm, Sweden) after histologic confirmation. A 52-year-old man presented with diplopia, gait disturbance, and sensory disturbance. Magnetic resonance imaging demonstrated a large cystic mass at ambient cistern on the right side. Subtotal excision followed by Gamma Knife surgery was undertaken. His neurologic symptoms disappeared with radiologic reduction in size at 15-month follow-up. Because Gamma Knife can manage trochlear nerve schwannomas well, surgical excision should be reserved for large ones and limited to subcapsular or subtotal removal with the expectation of possible recovery of neurologic dysfunction.

 
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