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The Surgical Management of Trigeminal Schwannomas

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Abstract

Schwannomas arising from the trigeminal nerves are the second most common type of intracranial schwannomas, representing 0.8–8 % of all intracranial schwannomas. These tumors are usually benign, isolated, and slow growing. They may occur in multiple sites when associated with neurofibromatosis type 2 (NF2). Trigeminal schwannomas (TSs) tend to occur in middle-aged patient; the highest incidences are between the ages of 38 and 40 years and are more common in women. Patients with TSs frequently complain of trigeminal nerve-related symptoms, but they may also be asymptomatic. In a recent review of the literature, Samii et al. reported trigeminal nerve symptoms in 51 % of patients, followed by headache (16 %) and diplopia (11 %). Prior to the advent of computed tomography (CT) and magnetic resonance (MR) imaging, diagnosis of TS was difficult. The treatment of choice remains resection. In 1918, Frazier reported the first removal of TS. Very high mortality has been associated with surgical treatment prior to the late 1950s. Since then, in addition of a large series of 111 patients, several small series have demonstrated positive results and low mortality and morbidity rates associated with complete resection. Different surgical approaches may be used depending on the location and extension of the lesion.

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Authors and Affiliations

  1. Neurosurgical Department, Neurological Institute of Curitiba, R. Jeremias Maciel Perretto, 300, Curitiba, 80210-310, Brazil

    Ricardo Ramina MD, PhD, Maurício Coelho Neto MD, André Giacomelli Leal MD, Erasmo Barros da Silva Jr. MD & Lucas Alves Aurich MD

  2. Neurosurgical Department, University of Campinas, Campinas, Brazil

    Yvens Barbosa Fernandes MD, PhD

Authors
  1. Ricardo Ramina MD, PhD
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  2. Maurício Coelho Neto MD
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  3. Yvens Barbosa Fernandes MD, PhD
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  4. André Giacomelli Leal MD
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  5. Erasmo Barros da Silva Jr. MD
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  6. Lucas Alves Aurich MD
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Correspondence to Ricardo Ramina MD, PhD .

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Editors and Affiliations

  1. Neurosurgical Department, Neurological Institute of Curitiba (INC), Curitiba, Brazil

    Ricardo Ramina

  2. Neurosurgical Department, Santa Paula Hospital, São Paulo, Brazil

    Paulo Henrique Pires de Aguiar

  3. Dept. of Neurosurgery, Eberhard-Karls University Hospital, Tübingen, Baden-Württemberg, Germany

    Marcos Tatagiba

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Ramina, R., Neto, M.C., Fernandes, Y.B., Leal, A.G., da Silva, E.B., Aurich, L.A. (2014). The Surgical Management of Trigeminal Schwannomas. In: Ramina, R., de Aguiar, P., Tatagiba, M. (eds) Samii's Essentials in Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54115-5_21

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  • DOI: https://doi.org/10.1007/978-3-642-54115-5_21

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