INTRODUCTION

Case of Ms. R – a 28 year old lady with a tumour arising from the 5th cranial nerve.

Mrs. R Preoprerative Scan

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Pre-operative images of the lady with a large tumor (white arrows) arising from the fifth cranial nerve (the nerve that subserves sensation to a large area of the head and face and also controls the muscles for chewing). The location of the tumor makes its removal challenging. The tumor is abutting on and compressing the brain stem (vital area controlling consciousness, breathing, heartbeat among others marked with black arrows). The tumor was removed through a microsurgical approach.

HISTORY

She presented with severe pain over the left half of the face mimicking trigeminal neuralgia. This underlines the importance of imaging in patients with trigeminal neuralgia. It is not safe to treat patients without ruling out a tumor.

CASE PRESENTATION

Investigations revealed that the patient had a large tumor arising from the fifth cranial nerve. This is a vital nerve as is subserves sensation to a large part of the head and face. And it also controls the muscles which allow us to perform the not-unimportant function of chewing. A tumour located in this region presents its own set of challenges. It abuts on and compresses the brain stem which among other things performs the vital functions of controlling consciousness, breathing and heartbeat. Naturally, this makes it essential for life itself.

The tumour was approached through a retro mastoid craniotomy. Over the course of a 6 hour procedure, surgeons were able to successfully remove the entire tumour.

OUTCOME

Within 3 to 4 hours, patient was conscious, had speech and was walking around. She was discharged in just 5. We are happy to report she has made a complete recovery and has returned to normal life.

Bullet retrieved after surgery

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Post-operative contrast enhanced MRI scans showing no tumor and no areas of abnormal enhancement.

Schwannomas are mostly benign nerve sheath tumors which normally produce the insulating myelin sheath covering peripheral nerves. These tumors are composed of schwann cells.

Trigeminal Schwannomas are the second most common type of intracranial schwannoma. They mostly occur in areas with multiple functional activities and hence may present with a range of symptoms. Sita Bhateja Hospital has a record of successfully treating many patients diagnosed with Trigeminal Schwannomas.

Worried about the complications related to the tumor arising from the cranial nerve? Get in touch with the team of neurosurgery specialists with vast experience in the removal of intra-cranial tumors – https://www.sbshospital.com/get-in-touch/






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