Takumi I, Isayama K, Osamura R Y, Kobayashi S, Teramoto A
Department of Neurosurgery, Neurological Institute, Nippon Medical School, Chiba Hokuso Hospital, Japan.
Acta Neurochir (Wien). 2005 Nov;147(11):1189-92; discussion 1192. doi: 10.1007/s00701-005-0618-z. Epub 2005 Sep 12.
We report a rare intracisternal C1 posterior root neurinoma in a 35-year-old man without neurofibromatosis who presented with headache, nuchal pain, bilateral motor weakness of the upper extremities, and numbness in the right distal upper extremity. CT and MRI study showed a 20-mm intracisternal lesion at the foramen magnum. At surgery, there was an anastomosis between the C1 posterior root and a spinal accessory nerve at the site of the tumor; the root from the collateral sulcus of this C1 root was absent. Postoperatively, the patient remains free of symptoms. Foramen magnum neurinomas have been described as accessory nerve tumors. We present new anatomical consideration regarding this lesion.
我们报告了一例罕见的枕骨大孔内C1后根神经鞘瘤，患者为一名35岁男性，无神经纤维瘤病，表现为头痛、颈部疼痛、双侧上肢运动无力以及右上肢远端麻木。CT和MRI检查显示枕骨大孔处有一个20毫米的枕骨大孔内病变。手术中发现，在肿瘤部位C1后根与副神经之间存在吻合；该C1神经根侧副沟发出的神经根缺如。术后，患者症状消失。枕骨大孔神经鞘瘤曾被描述为副神经肿瘤。我们对此病变提出了新的解剖学见解。
