title: Trochlear nerve schwannoma with intratumoral hemorrhage presenting with persistent hiccups: a case report.
abstract: Trochlear nerve schwannoma without neurofibromatosis is extremely rare. To our knowledge, only 31 surgical cases have been reported to date, and only 2 cases of trochlear nerve schwannoma with intratumoral hemorrhage have been reported. None of those cases presented with persistent hiccups. We report the case of a 44-year-old man with trochlear nerve schwannoma associated with intratumoral hemorrhage who presented with a 10-day history of persistent hiccups. Computed tomography and magnetic resonance imaging revealed a solid tumor with a 3-cm diameter and intratumoral hemorrhage in the left petroclival region that compressed the midbrain and pons. Subtotal removal of the tumor was performed via the zygomatic transpetrosal approach. Intraoperative findings revealed a tumor arising from the trochlear nerve. The histologic diagnosis was schwannoma of Antoni type A cells with intratumoral hemorrhage. Although the patient's left trochlear nerve palsy worsened temporarily, his postoperative course was uneventful. We present this rare case and discuss the mechanism underlying the patient's persistent hiccups.
authors.affiliation: Department of Neurosurgery, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan ; Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Hatae
authors.affiliation: Department of Neurosurgery, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyazono
authors.affiliation: Department of Neurosurgery, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Kohri
authors.affiliation: Department of Neurosurgery, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Pathology, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Naito
keywords: intratumoral hemorrhage; persistent hiccup; trochlear nerve schwannoma
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