Browse > Article
http://dx.doi.org/10.3340/jkns.2014.56.2.152

Intracisternal Cranial Root Accessory Nerve Schwannoma Associated with Recurrent Laryngeal Neuropathy  

Jin, Sung-Won (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University)
Park, Kyung-Jae (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University)
Park, Dong-Hyuk (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University)
Kang, Shin-Hyuk (Department of Neurosurgery, Korea University Medical Center, College of Medicine, Korea University)
Publication Information
Journal of Korean Neurosurgical Society / v.56, no.2, 2014 , pp. 152-156 More about this Journal
Abstract
Intracisternal accessory nerve schwannomas are very rare; only 18 cases have been reported in the literature. In the majority of cases, the tumor origin was the spinal root of the accessory nerve and the tumors usually presented with symptoms and signs of intracranial hypertension, cerebellar ataxia, and myelopathy. Here, we report a unique case of an intracisternal schwannoma arising from the cranial root of the accessory nerve in a 58-year-old woman. The patient presented with the atypical symptom of hoarseness associated with recurrent laryngeal neuropathy which is noted by needle electromyography, and mild hypesthesia on the left side of her body. The tumor was completely removed with sacrifice of the originating nerve rootlet, but no additional neurological deficits. In this report, we describe the anatomical basis for the patient's unusual clinical symptoms and discuss the feasibility and safety of sacrificing the cranial rootlet of the accessory nerve in an effort to achieve total tumor resection. To our knowledge, this is the first case of schwannoma originating from the cranial root of the accessory nerve that has been associated with the symptoms of recurrent laryngeal neuropathy.
Keywords
Schwannoma; Accessory nerve; Intracisternal; Recurrent laryngeal neuropathy;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Bakar B : The jugular foramen schwannomas : review of the large surgical series. J Korean Neurosurg Soc 44 : 285-294, 2008   DOI
2 Benninger B, McNeil J : Transitional nerve : a new and original classification of a peripheral nerve supported by the nature of the accessory nerve (CN XI). Neurol Res Int 2010 : 476018, 2010
3 Bulsara KR, Sameshima T, Friedman AH, Fukushima T : Microsurgical management of 53 jugular foramen schwannomas : lessons learned incorporated into a modified grading system. J Neurosurg 109 : 794-803, 2008   DOI
4 Caputi F, de Sanctis S, Gazzeri G, Gazzeri R : Neuroma of the spinal accessory nerve disclosed by a subarachnoid hemorrhage : case report. Neurosurgery 41 : 946-950, 1997   DOI
5 Chang KC, Huang JS, Liu KN, Tsai CS, Chen TY : Neurinoma of the spinal accessory nerve : report of a case. J Formos Med Assoc 89 : 593-597, 1990
6 Christoferson LA, Leech RW, Grossman M : Intracranial neurilemoma of the spinal accessory nerve. Surg Neurol 18 : 18-20, 1982   DOI
7 de Oliveira E, Rhoton AL Jr, Peace D : Microsurgical anatomy of the region of the foramen magnum. Surg Neurol 24 : 293-352, 1985   DOI   ScienceOn
8 DeToledo JC, David NJ : Innervation of the sternocleidomastoid and trapezius muscles by the accessory nucleus. J Neuroophthalmol 21 : 214-216, 2001   DOI
9 DeToledo JC, Dow R : Sternomastoid function during hemispheric suppression by amytal : insights into the inputs to the spinal accessory nerve nucleus. Mov Disord 13 : 809-812, 1998   DOI   ScienceOn
10 Falla D, Dall'Alba P, Rainoldi A, Merletti R, Jull G : Repeatability of surface EMG variables in the sternocleidomastoid and anterior scalene muscles. Eur J Appl Physiol 87 : 542-549, 2002   DOI
11 Fink LH, Early CB, Bryan RN : Glossopharyngeal schwannomas. Surg Neurol 9 : 239-245, 1978
12 Hakuba A, Hashi K, Fujitani K, Ikuno H, Nakamura T, Inoue Y : Jugular foramen neurinomas. Surg Neurol 11 : 83-94, 1979
13 Julow J : Neurinoma of spinal accessory nerve. Report of two cases. Acta Neurochir (Wien) 69 : 219-224, 1983   DOI
14 Jung TY, Jung S, Kim IY, Kang SS : Intracisternal schwannoma of the spinal accessory nerve : a case report. Skull Base 16 : 175-179, 2006   DOI
15 Kawaguchi S, Ohnishi H, Yuasa T, Hashimoto H : [Spinal accessory nerve neurinoma in the C2 spinal canal. Case report]. Neurol Med Chir (Tokyo) 27 : 1190-1194, 1987   DOI
16 Lanotte M, Massaro F, Scienza R, Faccani G : Intracisternal schwannoma of the spinal accessory nerve presenting as a normal pressure hydrocephalus syndrome. Case report and review of the literature. Neurosurg Rev 17 : 225-227, 1994   DOI
17 Kaye AH, Hahn JF, Kinney SE, Hardy RW Jr, Bay JW : Jugular foramen schwannomas. J Neurosurg 60 : 1045-1053, 1984   DOI
18 Kaynar MY, Hanci M, Sarioglu AC : Intraspinal schwannoma of the accessory nerve. Br J Neurosurg 13 : 429-431, 1999   DOI
19 Kurokawa R, Tabuse M, Yoshida K, Kawase T : Spinal accessory schwannoma mimicking a tumor of the fourth ventricle : case report. Neurosurgery 54 : 510-514; discussion 514, 2004   DOI   ScienceOn
20 Leonetti JP, Anderson DE, Marzo SJ, Origitano TC, Shirazi M : Intracranial schwannomas of the lower cranial nerves. Otol Neurotol 27 : 1142-1145, 2006   DOI
21 Linn J, Moriggl B, Schwarz F, Naidich TP, Schmid UD, Wiesmann M, et al. : Cisternal segments of the glossopharyngeal, vagus, and accessory nerves : detailed magnetic resonance imaging-demonstrated anatomy and neurovascular relationships. J Neurosurg 110 : 1026-1041, 2009   DOI
22 Matsushima T, Fukui M, Matsunaga M, Kitamura K, Hasuo K : Accessory nerve neurinoma mimicking a brain stem tumor on angiography : report of a case. Neurosurgery 16 : 839-842, 1985   DOI
23 Nishiura I, Koyama T : Neurinoma of the spinal accessory nerve. A case report. Neurochirurgia (Stuttg) 27 : 154-157, 1984
24 Ohkawa M, Fujiwara N, Takashima H, Satoh K, Tanabe M, Honjo Y, et al. : Radiologic manifestation of spinal accessory neurinoma : a case report. Radiat Med 14 : 269-273, 1996
25 Pearson AA, Sauter RW, Herrin GR : The accessory nerve and its relation to the upper spinal nerves. Am J Anat 114 : 371-391, 1964   DOI
26 Sadatomo T, Yuki K, Migita K, Hidaka T, Kurisu K : [Accessory nerve sch-wannoma of the intracisternal type : a case report]. No Shinkei Geka 38 : 831-837, 2010
27 Sperti L, Midrio M, Xzmin E : Effects of selective intracranial section and stimulation of vago-accessory roots. IV. Reflex activity of 'accessory' cardio-inhibitory neurons. Experientia 18 : 97, 1962   DOI
28 Sedney CL, Nonaka Y, Bulsara KR, Fukushima T : Microsurgical management of jugular foramen schwannomas. Neurosurgery 72 : 42-46; discussion 46, 2013   DOI
29 Shiroyama Y, Inoue S, Tsuha M, Abiko S, Aoki H : [Intracranial neurinomas of the jugular foramen and hypoglossal canal]. No Shinkei Geka 16 : 313-319, 1988
30 Soo SJ, Irie K, Fujiwara T, Kuyama H, Nagao S : [A case of accessory nerve neurinoma presenting an intracisternal tumor]. No Shinkei Geka 23 : 723-726, 1995
31 Tatebayashi K, Tanaka Y, Numata H, Kawakami S, Kamitani H, Watanabe T : Schwannoma of the spinal accessory nerve in the cisterna magna. Surg Neurol 59 : 217-222; discussion 222, 2003   DOI
32 Tsuchiya K, Machida T, Maehara T, Iio M : [Case of accessory nerve neurinoma]. Rinsho Hoshasen 27 : 1375-1378, 1982
33 Tsukamoto H, Hikita T, Takaki T : Cerebellopontine angle meningioma associated with cranial accessory nerve neurinoma--case report. Neurol Med Chir (Tokyo) 34 : 225-229, 1994   DOI
34 Tubbs RS, Shoja MM, Loukas M, Lancaster J, Mortazavi MM, Hattab EM, et al. : Study of the cervical plexus innervation of the trapezius muscle. J Neurosurg Spine 14 : 626-629, 2011   DOI