PMID: 11904046Mar 21, 2002Paper

Trochlear nerve neuroma manifested with intractable atypical facial pain: case report

Neurosurgery
Igor Veshchev, Sergey Spektor

Abstract

Trochlear nerve neuromas are extremely rare. Seventeen surgical cases of this pathological condition have been reported in the English literature. The presented case is distinct from previous reports. A 26-year-old woman presented with atypical facial pain. The neurological examination results were normal. Magnetic resonance imaging revealed a left parasellar mass. A left pterional craniotomy was performed, providing access to the left parasellar area. After incision of the tentorial edge, the tumor was observed to originate from the short segment of the trochlear nerve that runs between the tentorial leaves. The neuroma was totally removed. The facial pain resolved immediately after surgery. Although facial dysesthesias have been noted among patients with trochlear nerve neuromas, here the atypical facial pain was the only clinical manifestation. In all previously reported cases, neuromas originated from the cisternal segment of the trochlear nerve (always before the site of nerve entrance into the tentorial leaves) and expanded mainly into the prepontine and interpeduncular cisterns. Subtemporal and suboccipital approaches were used. In this case, the tumor arose from the short segment of the nerve running between the tentori...Continue Reading

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Citations

Sep 9, 2016·The Journal of Craniofacial Surgery·Pengfei LiuWenchuan Zhang
Apr 1, 2006·Neurosurgery·Shigeo OhbaTakeshi Kawase
May 26, 2009·Neurologia Medico-chirurgica·Misaki KohamaTeiji Tominaga
Sep 17, 2010·Strabismus·H M ElfleinS Pitz
Apr 10, 2014·Case Reports in Neurological Medicine·Andrew B Boucher, L Madison Michael

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