[Diagnosis of neurinomas of the Gasserian ganglion]

The article analyses the findings of clinical and X-ray examination in 39 patients in two types of growth of neurinoma of the gasserian ganglion: with localization within the boundaries of the middle cranial fossa (22) and with the formation of tumor nodes in the middle and posterior cranial fossae (17). The first symptoms of the disease were paresthesia or numbness and continuous pain mostly in the zone innervated by the 1st--2nd pair of the trigeminal nerve, absence of corneal reflexes, high lumbar cerebrospinal fluid pressure, and protein-cellular dissociation in the cerebrospinal fluid. The craniograms revealed destruction of the floor of the middle cranial fossa with involvement of the walls of the f. ovale, spinosum et lacerum and the apex of the pyramid of the temporal bone. Carotid angiography demonstrated typical displacement of the carotid siphon to the midline, to the front, or to the back. The middle cerebral artery was moderately displaced upward and an arched art. chorioidea, anterior was noted. Growth of the neurinoma into the posterior cranial fossa was attended with displacement and deformity of a. basilaris et cerebellaris superior and the veins of the posterior cranial fossa. The ventriculograms showed compression of the inferior horn of the lateral ventricle and moderate compression of the caudal parts of the fourth ventricle and aqueduct of Sylvius. Comprehensive generalization of all the findings gained from examination of the patient is necessary in determining the topics and type of the growth of a neurinoma of the gasserian ganglion.