Transventricular Transvelar Approach to the Trochlear Nerve Schwannoma: A Novel Technique to the Lesions of the Inferior Pineal Region.

Transventricular Transvelar Approach to the Trochlear Nerve Schwannoma: A Novel Technique to the Lesions of the Inferior Pineal Region.

World Neurosurg. 2018 Mar 27;:

Authors: Farrokhi MR, Ghaffarpasand F, Taghipour M, Derakhshan N

Abstract
OBJECTIVES: The schwannoma of the trochlear nerve is rare and originates mostly from the distal parts in interpeduncular cistern. Lesion of the proximal segment in the inferior pineal region is extremely rare. Because of the rarity of the disease, the surgical approach to this region for the resection of trochlear nerve schwannoma has not been well documented in the literature. We herein describe an innovative and novel approach for the successful resection of the trochlear nerve schwannoma.
METHORDS: A 12-year-old boy presented with occipital headache, abnormal gait and disturbed conjoined eye movement. He was diagnosed with a lesion in the inferior pineal region compressing the superior medullary velum into the roof of the fourth ventricle. Bilateral midline suboccipital craniotomy was performed and the fourth ventricle was exposed. The lesion was approached through the fourth ventricle superior medullary velum (transventricular transvelar approach). The lesion was totally resected and his histopathology examination revealed trochlear schwannoma.
RESULTS: The patient's symptoms resolved and he had no recurrence at 12-year follow up with normal eye movement and vision.
CONCLUSION: Transventricular transvelar approach can be a feasible and safe approach to the lesion of the lower part of the pineal region being pushed through the superior medullary velum.

PMID: 29602005 [PubMed - as supplied by publisher]

https://ift.tt/2pUt3rN