Qilu Hospital of Shandong University, Department of Neurosurgery, Jinan, China.
Turk Neurosurg. 2024;34(5):920-925. doi: 10.5137/1019-5149.JTN.46250-24.2.
Vagus nerve schwannoma is an infrequently occurring schwannoma, in which a distinct subtype exists wherein the tumor is confined to the cerebellomedullary cistern without invading the jugular foramen. This unique tumor is called purely intracranial vagal schwannoma. In this case report, we present a case of purely intracranial vagal schwannoma in its asymptomatic early phase, incidentally discovered during surgery performed on a patient with hemifacial spasm. Because of the small size of the tumor, we definitively recognized that it originated from the second rootlet on the caudal side. The tumor was totally resected uneventfully and a favorable prognosis was achieved. Furthermore, we conducted a comprehensive literature review to summarize the classification, origin, and surgical complications associated with this rare tumor type. Based on our literature review, we propose that: 1) the origin of tumor is related to the time of onset of symptoms, 2) nearly all purely intracranial vagal schwannomas can be entirely resected and favorable prognosis can be achieved, and 3) surgeons should be aware of potential cardiovascular complications during surgical procedures.
迷走神经鞘瘤是一种罕见的神经鞘瘤，其中存在一个明显的亚型，肿瘤局限于小脑延髓池而不侵犯颈静脉孔。这种独特的肿瘤被称为纯粹的颅内迷走神经鞘瘤。在本病例报告中，我们介绍了一例无症状早期的纯粹颅内迷走神经鞘瘤病例，该病例是在一名面肌痉挛患者的手术中偶然发现的。由于肿瘤较小，我们明确地识别出它起源于尾部的第二神经根。肿瘤被完全无并发症地切除，取得了良好的预后。此外，我们进行了全面的文献回顾，总结了这种罕见肿瘤类型的分类、起源和手术并发症。基于我们的文献回顾，我们提出：1）肿瘤的起源与症状出现的时间有关，2）几乎所有的纯粹颅内迷走神经鞘瘤都可以完全切除，预后良好，3）外科医生在手术过程中应该注意潜在的心血管并发症。
