eMedicine Specialties > Radiology > Brain/Spine

Schwannoma, Cranial Nerve: Follow-up

Author: Mahesh Jayaraman, MD, Interventional Neuroradiology Fellow, Department of Radiology, Stanford University Medical Center
Coauthor(s): Lawrence M Davis, MD, Assistant Professor of Diagnostic Imaging (Clinical), Department of Diagnostic Imaging, Brown Medical School
Contributor Information and Disclosures

Updated: Oct 18, 2007

Intervention

Stereotactic radiosurgery (ie, gamma knife radiosurgery) largely has replaced surgical resection for the treatment of vestibular schwannomas, particularly when the lesions do not compress the brainstem. Lesions should be smaller than 3 cm. Studies have demonstrated rates of tumor control (ie, lesion stabilizes or shrinks) of greater than 95% and a rate of hearing preservation of approximately 70%. Although less well studied, other CN schwannomas also can be treated with radiosurgery.9,10,11

Medicolegal Pitfalls

  • Failure to perform MRI when CN tumors are suggested.
  • In particular, CT scans of the brain are inadequate for evaluating CNs, and the reliance of negative CT findings to exclude a CN lesion may lead to liability.
 


More on Schwannoma, Cranial Nerve

Overview: Schwannoma, Cranial Nerve
Imaging: Schwannoma, Cranial Nerve
Follow-up: Schwannoma, Cranial Nerve
Multimedia: Schwannoma, Cranial Nerve
References
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References

  1. Atlas S, ed. Magnetic Resonance Imaging of the Brain and Spine. 2nd ed. Lippincott-Raven;1996:781-6.

  2. Chung SY, Kim DI, Lee BH, et al. Facial nerve schwannomas: CT and MR findings. Yonsei Med J. Apr 1998;39(2):148-53. [Medline].

  3. Shah N, Sibtain A, Saunders MI, et al. High FDG uptake in a schwannoma: a PET study. J Comput Assist Tomogr. Jan-Feb 2000;24(1):55-6. [Medline].

  4. Yuh WT, Wright DC, Barloon TJ, et al. MR imaging of primary tumors of trigeminal nerve and Meckel''s cave. AJR Am J Roentgenol. Sep 1988;151(3):577-82. [Medline].

  5. Wilson-Pauwels L, Akesson EJ, Stewart PA. Cranial Nerves: Anatomy and Clinical Comments. Decker BC;1998.

  6. Gomez Beldarrain M, Fernandez Canton G, Garcia-Monco JC. Hypoglossal schwannoma: an uncommon cause of twelfth-nerve palsy. Neurologia. Apr 2000;15(4):182-3. [Medline].

  7. Schmalbrock P, Chakeres DW, Monroe JW, et al. Assessment of internal auditory canal tumors: a comparison of contrast- enhanced T1-weighted and steady-state T2-weighted gradient-echo MR imaging. AJNR Am J Neuroradiol. Aug 1999;20(7):1207-13. [Medline].

  8. Colreavy MP, Lacy PD, Hughes J, et al. Head and neck schwannomas--a 10 year review. J Laryngol Otol. Feb 2000;114(2):119-24. [Medline].

  9. Bennett M, Haynes DS. Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am. Jun 2007;40(3):589-609, ix-x. [Medline].

  10. Backous DD, Pham HT. Guiding patients through the choices for treating vestibular schwannomas: balancing options and ensuring informed consent. Otolaryngol Clin North Am. Jun 2007;40(3):521-40, viii-ix. [Medline].

  11. Kabil MS, Shahinian HK. A series of 112 fully endoscopic resections of vestibular schwannomas. Minim Invasive Neurosurg. Dec 2006;49(6):362-8. [Medline].

  12. Eldevik OP, Gabrielsen TO, Jacobsen EA. Imaging findings in schwannomas of the jugular foramen. AJNR Am J Neuroradiol. Jun-Jul 2000;21(6):1139-44. [Medline].

  13. Gilmer-Hill HS, Kline DG. Neurogenic tumors of the cervical vagus nerve: report of four cases and review of the literature. Neurosurgery. Jun 2000;46(6):1498-503. [Medline].

  14. Ginsberg F, Peyster RG, Rose WS, Drapkin AJ. Sixth nerve schwannoma: MR and CT demonstration. J Comput Assist Tomogr. May-Jun 1988;12(3):482-4. [Medline].

  15. Katsumata Y, Maehara T, Noda M, Shirouzu I. Neurinoma of the oculomotor nerve: CT and MR features. J Comput Assist Tomogr. Jul-Aug 1990;14(4):658-61. [Medline].

  16. Mackle T, Rawluk D, Walsh RM. Atypical clinical presentations of vestibular schwannomas. Otol Neurotol. Jun 2007;28(4):526-8. [Medline].

  17. Weissman JL. Hearing loss. Radiology. Jun 1996;199(3):593-611. [Medline].

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Further Reading

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Keywords

neuroma; CN schwannomas; Schwann cells; vestibular schwannomas; trigeminal schwannomas; facial schwannomas; glossopharyngeal schwannomas; vagus schwannomas; spinal accessory schwannomas; oculomotor schwannomas; hypoglossal schwannomas; abducens schwannomas; trochlear schwannomas; neurofibromatosis type 2; NF2; multiple inherited schwannomas, meningiomas, and ependymomas syndrome; MISME syndrome

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Contributor Information and Disclosures

Author

Mahesh Jayaraman, MD, Interventional Neuroradiology Fellow, Department of Radiology, Stanford University Medical Center
Mahesh Jayaraman, MD is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

Lawrence M Davis, MD, Assistant Professor of Diagnostic Imaging (Clinical), Department of Diagnostic Imaging, Brown Medical School
Lawrence M Davis, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, American Society of Neuroradiology, Radiological Society of North America, and Rhode Island Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Mahesh R Patel, MD, Chief of MRI, Department of Radiology, Santa Clara Valley Medical Center
Mahesh R Patel, MD is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

James G Smirniotopoulos, MD, Professor of Radiology, Neurology, and Biomedical Informatics, Chairman, Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences
James G Smirniotopoulos, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, American Society of Head and Neck Radiology, American Society of Neuroradiology, American Society of Pediatric Neuroradiology, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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