Ipsilateral beating nystagmus after acoustic schwannoma resection.
OBJECTIVE
To highlight the alert value of an ipsilateral beating nystagmus to detect any potential vascular complication in the early postoperative course of acoustic schwannoma (AS) surgery.


METHODS
In a series of 432 cases of AS operated by the same surgeons between January 1991 and December 2000, two cases of vascular complications were detected by an ipsilateral beating nystagmus toward the operated side.


RESULTS
One case of arterial infarction giving rise to a partial AICA syndrome and one case of hematoma of the cerebello-pontine angle (CPA) were revealed by an ipsilateral beating nystagmus. It was the first or the only objective neurologic sign encountered in the early postoperative course of AS surgery.


CONCLUSIONS
An ipsilateral beating nystagmus after AS resection, even appearing as the only abnormal objective neurologic finding, should always raise suspicion of a brain stem event. Early extubation is recommended for systematic neurologic assessment in order to detect as quickly as possible any potential vascular complication in the early postoperative course of AS.
Kania
Romain E
RE
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris, France.
Herman
Philippe
P
Lot
Guillaume
G
Huy
Patrice Tran Ba
PT
D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D016543:Central Nervous System Neoplasms / Q000601:surgery*; D002530:Cerebellopontine Angle; D002531:Cerebellum / Q000098:blood supply; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000503:physiopathology; D013506:Otologic Surgical Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000175:diagnosis* / Q000209:etiology