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Hypoglossal neurinoma--two case reports.

M Hoshi1, K Yoshida, K Ogawa

  • 1Department of Neurosurgery, School of Medicine, Keio University, Tokyo.

Neurologia Medico-Chirurgica
|October 6, 2000
PubMed
Summary

Hypoglossal neurinoma surgery requires careful management of venous collaterals to prevent complications. Preserving these vessels is crucial for avoiding dural venous sinus thrombosis and improving patient outcomes.

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Area of Science:

  • Neurosurgery
  • Neurology
  • Oncology

Background:

  • Hypoglossal neurinomas are rare tumors that can extend both intracranially and extracranially.
  • Surgical resection is the primary treatment modality for these tumors.
  • Intracranial and extracranial extension poses surgical challenges, particularly regarding neurovascular structures.

Observation:

  • Two cases of intra- and extracranial hypoglossal neurinoma are presented.
  • Case 1: A 63-year-old male with trigeminal neuralgia and hypoglossal nerve paresis underwent suboccipital craniectomy. Over-coagulation of venous collaterals led to dural venous sinus thrombosis and cerebellar infarction, resulting in death.
  • Case 2: A 48-year-old male with multiple cranial nerve palsies and cerebellar signs underwent successful tumor removal by opening the hypoglossal canal and jugular foramen, preserving venous collaterals.

Findings:

  • Aggressive management of venous collaterals, specifically emissary veins, during suboccipital craniectomy can lead to severe postoperative complications such as dural venous sinus thrombosis and cerebellar infarction.
  • Meticulous surgical technique that preserves venous collaterals, including careful dissection around the hypoglossal canal and jugular foramen, is vital for preventing such complications.

Implications:

  • Preservation of venous collaterals during the surgical resection of intra- and extracranial hypoglossal neurinomas is paramount for patient safety and favorable outcomes.
  • This case series highlights the critical importance of understanding and protecting venous drainage pathways to avoid potentially fatal postoperative complications in neurosurgical oncology.

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