Internal carotid plexus schwannoma of the cavernous sinus: case report.
OBJECTIVE
Schwannomas of the central nervous system usually originate from the vestibular nerve and occasionally originate from the trigeminal nerve. Sympathetic plexus schwannomas are extremely rare and have never been noted within the cavernous sinus.


METHODS
A 23-year-old man experienced occasional double vision for a period of 6 months. Magnetic resonance imaging studies revealed an isointense lesion, with enhancement after gadolinium administration, located inferomedial to the internal carotid artery within the left cavernous sinus.


METHODS
We explored the cavernous sinus via a left-sided extradural-pterional approach and found the tumor inferomedial to the cavernous segment of the internal carotid artery. Microsurgical gross total resection of the tumor was performed. The IIIrd (oculomotor) to VIth (abducens) cranial nerves within the cavernous sinus were not related to the tumor and were preserved. The operative findings and the anatomic location of the tumor demonstrated that it originated from the internal carotid plexus within the cavernous sinus. The patient's postoperative course was uneventful, and he exhibited no cranial nerve deficits. However, incomplete Horner's syndrome was present on the treated side.


CONCLUSIONS
We present the first reported case of an internal carotid plexus schwannoma, and we describe in detail its anatomic and neuroradiological characteristics. The microneurosurgical resection of this unusual tumor within the cavernous sinus was successful and without morbidity.
Türe
Uğur
U
Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey. ugurture@turk.net
Seker
Aşkin
A
Kurtkaya
Ozlem
O
Pamir
M Necmettin
MN
D000328:Adult; D002343:Carotid Artery, Internal / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D017783:Superior Cervical Ganglion / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed