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J Neurol Surg Rep 2012; 73(01): 032-036
DOI: 10.1055/s-0032-1311757
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Large Dumbbell-Shaped C1 Schwannoma Presenting as a Foramen Magnum Mass

Jody Helms
1   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Lattimore Madison Michael II
1   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee
2   Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee
› Author Affiliations
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Publication History

08 September 2011

23 November 2011

Publication Date:
20 April 2012 (online)

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Abstract

Schwannomas involving the foramen magnum commonly originate from the lower cranial nerves, but they are rarely found arising from the first cervical root. To date, very few cases have been described in the literature. The majority involve either the intradural or extradural compartment but not both. We report the second case of a dumbbell-shaped schwannoma arising from the first cervical root. Our patient presented with hemisensory deficits secondary to brainstem compression at the level of the foramen magnum. The patient underwent a far lateral approach, and a gross total resection was achieved. Preoperative suspicion of the diagnosis is helpful in anticipating displacement and avoiding damage to the surrounding neurovascular structures.

Keywords

schwannoma - C1 - first cervical nerve root - dumbbell shape - foramen magnum mass
 

  • References

  • 1 Rhoton Jr AL. Cranial Anatomy and Surgical Approaches. Baltimore, MD: Lippincott Williams & Wilkins; 2003: 600
    Google Scholar
  • 2 Tubbs RS, Loukas M, Yalçin B, Shoja MM, Cohen-Gadol AA. Classification and clinical anatomy of the first spinal nerve: surgical implications. J Neurosurg Spine 2009; 10 (4) 390-394
    CrossrefPubMedGoogle Scholar
  • 3 Ouaknine G, Nathan H. Anastomotic connections between the eleventh nerve and the posterior root of the first cervical nerve in humans. J Neurosurg 1973; 38 (2) 189-197
    PubMedGoogle Scholar
  • 4 Guidetti B, Spallone A. Benign extramedullary tumors of the foramen magnum. Adv Tech Stand Neurosurg 1988; 16: 83-120
    PubMedGoogle Scholar
  • 5 George B, Lot G. Neurinomas of the first two cervical nerve roots: a series of 42 cases. J Neurosurg 1995; 82 (6) 917-923
    CrossrefPubMedGoogle Scholar
  • 6 Kalavakonda C, Sekhar LN, Jones RV, Rehaman AB. Intermittent vertebral artery compression caused by C1-root schwannoma: case report. Neurol Res 2000; 22 (7) 679-684
    PubMedGoogle Scholar
  • 7 Parlato C, Tessitore E, Schonauer C, Moraci A. Management of benign craniovertebral junction tumors. Acta Neurochir (Wien) 2003; 145 (1) 31-36
    CrossrefPubMedGoogle Scholar
  • 8 Kim JH, Lee JH, Park YK, Kwon TH, Chung HS. C-1 root schwannoma with aggressive lateral mass invasion. Yonsei Med J 2005; 46 (4) 575-578
    CrossrefPubMedGoogle Scholar
  • 9 Ueda R, Yoshida K, Kawase T. Intradural C-1 ventral root schwannomas treated by surgical resection via the lateral suboccipital transcondylar approach—three case reports. Neurol Med Chir (Tokyo) 2006; 46 (6) 298-301
    CrossrefPubMedGoogle Scholar
  • 10 Osborn AG. Tumors, cysts, and tumorlike lesions of the spine and spinal cord. In: Osborn AG. Diagnostic Neuroradiology. St Louis, MO: Mosby; 1994: 895-900
    Google Scholar
  • 11 Vishteh AG, Crawford NR, Melton MS, Spetzler RF, Sonntag VK, Dickman CA. Stability of the craniovertebral junction after unilateral occipital condyle resection: a biomechanical study. J Neurosurg 1999; 90 (1, Suppl) 91-98
    CrossrefPubMedGoogle Scholar