title: Dura-based giant intracranial schwannoma in the middle fossa.
abstract: A 49-year-old female presented with a rare giant schwannoma arising from the dura mater of the middle fossa manifesting as loss of left visual acuity. Magnetic resonance imaging revealed a heterogeneously enhanced giant mass in the left middle fossa. Surgery via the transsylvian approach confirmed the origin of the tumor between the left internal carotid artery and the trigeminal nerve in the lateral wall of the cavernous sinus. Elongated abducens nerve was confirmed, but no tumor adhesion to the abducens nerve was found. The tumor was closely attached to the dura mater of the middle fossa and the lateral wall of the cavernous sinus. The histological diagnosis was schwannoma. Both left oculomotor and abducens nerve pareses occurred immediately after the operation but gradually resolved over 3 months. The operative findings indicated that this schwannoma may have arisen from the meningeal branch of the trigeminal nerve in the dura mater of the middle fossa.
authors.affiliation: Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan. inutoshi@naramed-u.ac.jp
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Inui
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Morimoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Koshimae
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Nagata
authors.forename: Shuta
authors.initials: S
authors.lastname: Aketa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hironaka
authors.forename: Rinsei
authors.initials: R
authors.lastname: Tei
mesh_terms: D002426:Cavernous Sinus / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D035301:Cranial Fossa, Middle / Q000473:pathology* / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004388:Dura Mater / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008488:Medical Illustration; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D019635:Neurosurgical Procedures; D011183:Postoperative Complications; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000473:pathology; D020433:Trigeminal Nerve Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery