RESUMEN

Oculomotor nerve schwannoma in children not associated with neurofibromatosis is a rare disease, with 26 pediatric cases reported so far. There is no established treatment plan. A 7-year-old girl presented with oculomotor nerve palsy. Surgical reduction of the tumor combined with postoperative gamma knife surgery preserved the oculomotor nerve, improved oculomotor nerve function, and achieved tumor control during the observation period of 20 months. The combination of partial surgical resection and gamma knife surgery as a treatment strategy for oculomotor nerve schwannoma resulted in a good outcome.

Asunto(s)

Seno Cavernoso , Neurilemoma , Enfermedades del Nervio Oculomotor , Humanos , Femenino , Niño , Neurilemoma/cirugía , Neurilemoma/complicaciones , Seno Cavernoso/cirugía , Seno Cavernoso/diagnóstico por imagen , Enfermedades del Nervio Oculomotor/etiología , Enfermedades del Nervio Oculomotor/cirugía , Oftalmoplejía/etiología , Oftalmoplejía/cirugía , Radiocirugia/métodos , Neoplasias de los Nervios Craneales/cirugía , Neoplasias de los Nervios Craneales/complicaciones , Resultado del Tratamiento , Imagen por Resonancia Magnética

RESUMEN

The complication rate of stereotactic electroencephalography (SEEG) is generally low, but various types of postoperative hemorrhage have been reported. We presented an unusual hemorrhagic complication after SEEG placement. A 20-year-old man presented with suspected frontal lobe epilepsy. We implanted 11 SEEG electrodes in the bilateral frontal lobes and the left insula. Computed tomography after implantation showed intraparenchymal hemorrhage in the left temporal lobe and insula and subarachnoid hemorrhage in the left Sylvian cistern. Later, the point of vessel injury was revealed from the identification of a pseudoaneurysm, but this location was not along the planned or actual electrode trajectory. The cause of hemorrhage was suggested to be indirect injury from stretching of the arachnoid trabeculae by the puncture needle.