An isolated cavernous malformation of the sixth cranial nerve: A case report and review of literature.

Abducens nerve Cavernous hemangioma Cranial nerves Surgical resection

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2021
Historique:
received: 13 08 2021
accepted: 07 10 2021
entrez: 8 12 2021
pubmed: 9 12 2021
medline: 9 12 2021
Statut: epublish

Résumé

Isolated cavernous malformation (CM) of the abducens nerve has not been reported in the literature. Herein, the authors address the clinical importance of these lesions and review the reported cases of CM from 2014 to 2020. A 21-year-old man presented with binocular diplopia and headache from 2 months before his admission. The neurological examination revealed right-sided abducens nerve palsy. The brain MRI revealed an extra-axial pontomedullary lesion suggestive of a CM. The lesion was surgically removed. During the operation, the abducens nerve was resected considering the lesion could not be separated from the nerve and an anastomosis was performed using an interposition nerve graft and fibrin glue. Pathological examination of the resected lesion revealed that it was originated from within the nerve. The patient's condition improved in postoperative follow-ups. Surgical resection of the cranial nerves CMs is appropriate when progressive neurological deficits are present. If the lesion is originated from within the nerve, we suggest resection of the involved nerve and performing anastomosis. Novel MRI sequences might help surgeons to be prepared for such cases and fibrin glue can serve as an appropriate tool to perform anastomosis when end-to-end sutures are impossible to perform.

Sections du résumé

BACKGROUND BACKGROUND
Isolated cavernous malformation (CM) of the abducens nerve has not been reported in the literature. Herein, the authors address the clinical importance of these lesions and review the reported cases of CM from 2014 to 2020.
CASE DESCRIPTION METHODS
A 21-year-old man presented with binocular diplopia and headache from 2 months before his admission. The neurological examination revealed right-sided abducens nerve palsy. The brain MRI revealed an extra-axial pontomedullary lesion suggestive of a CM. The lesion was surgically removed. During the operation, the abducens nerve was resected considering the lesion could not be separated from the nerve and an anastomosis was performed using an interposition nerve graft and fibrin glue. Pathological examination of the resected lesion revealed that it was originated from within the nerve. The patient's condition improved in postoperative follow-ups.
CONCLUSION CONCLUSIONS
Surgical resection of the cranial nerves CMs is appropriate when progressive neurological deficits are present. If the lesion is originated from within the nerve, we suggest resection of the involved nerve and performing anastomosis. Novel MRI sequences might help surgeons to be prepared for such cases and fibrin glue can serve as an appropriate tool to perform anastomosis when end-to-end sutures are impossible to perform.

Identifiants

DOI: 10.25259/SNI_811_2021 PMID: 34877049 PMC: PMC8645491
pubmed: 34877049
doi: 10.25259/SNI_811_2021
pii: 10.25259/SNI_811_2021
pmc: PMC8645491
doi:

Types de publication

Case Reports

Langues

eng

Pagination

563

Informations de copyright

Copyright: © 2021 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Mohammad Samadian (M)

Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Seyed Farzad Maroufi (SF)

Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faculty of Medicine, Tehran University of Medical Sciences, Valiasr, Tehran, Iran.

Mehrdad Hosseinzadeh Bakhtevari (MH)

Department of Neurosurgery, Day General Hospital, Valiasr, Tehran, Iran.

Hamid Borghei-Razavi (H)

Department of Neurosurgery, Neurological Institute, Cleveland Clinic-Taussig Cancer Center, Cleveland, Ohio, United States.

Classifications MeSH