[Middle fossa neurinoma with proptosis and oculomotor palsy (author's transl)]

Proptosis and oculomotor palsy which occur with intracranial neurinoma are very rare.

A 29-year-old right-handed female was admitted to the Department of Neurosurgery, Hokkaido University School of Medicine on Sept. 6, 1975. Eight months before admission, the patient complained of double vision and one month later, noticed decreasing of right visual acuity. Four months before admission, right-sided ptosis occurred and she noticed right temporal visual field's defect. Two weeks before admission she became aware of proptosis of right side. On admission, the general examination and vital signs were normal. The neurological examination revealed right optic nerve atrophy, right oculomotor palsy and slight decreasing of right corneal reflex. Radiological examination revealed extracerebral mass lesion in the middle fossa. On Sept. 19, 1975, a right frontotemporal craniotomy was performed and a large dura-covered tumor was found. It was found to extend from the middle fossa to the superior orbital fissure and attached to the anterior wall of the middle fossa. The tumor expanded into the interdual space and tightly attached to the dura mater. Histological examination of the tumor revealed typical neurinoma. Reports on cases with middle fossa neurinoma were reviewed and the origin of the tumor was discussed. It was presumed that the origin of the tumor in this case was the dural branch of the trigeminal nerve in the middle fossa.