Schwannomas
These are also known as nerve sheath tumors.
These are benign or non-cancerous tumors.
They can arise from cranial nerves (nerves arising from brain) or spinal nerves (arising from spinal cord).
Commonest cranial nerve schwannomas are Vestibular (arising from hearing nerve) and then are Vagal and Trigeminal schwannomas.
Vestibular Schwannoma–
These are commonest among all schwannomas..
They are slowly growing tumors and patients usually seek doctor’s advice only when tumor has attained a significant size..
Presentation is imbalance, unsteadiness, visual blurring, progressive hearing loss on affected side.
Treatment-
Three standard methods of treatment are-
- Microsurgery
- Radiosurgery
- Observation
Microsurgery– It is a mainstay of treatment as it can eradicate the disease. Due to closeness of hearing and facial nerve, it is immense important to anatomically and possibly functionally preserve the Facial nerve. This is one of major neurosurgical operations.
Radiosurgery– Helpful in selective patients. Tumor size smaller than 1.5 cm responds well to radiosurgery. It helps stopping progress of growth. The dose of radiation is given in single dose.
Observation– For few patients, especially if the tumour is very small in size, patient asymptomatic and follows up scans reveal no obvious growth, may be a good option.
Pre op and Post op Scan
Follow up after 2 years
Vagal Schwannoma- This young 12 yrs old school student presented with gradual worsening headache, blurring vision and imbalance whilst walking.