title: Trochlear Nerve Schwannoma Treated with Gamma Knife after Excision: A Case Report and Review of the Literature.
abstract: Trochlear nerve schwannomas are extremely rare. We present a surgically excised case of trochlear nerve schwannoma followed by Gamma Knife (ELEKTA, Stockholm, Sweden) after histologic confirmation. A 52-year-old man presented with diplopia, gait disturbance, and sensory disturbance. Magnetic resonance imaging demonstrated a large cystic mass at ambient cistern on the right side. Subtotal excision followed by Gamma Knife surgery was undertaken. His neurologic symptoms disappeared with radiologic reduction in size at 15-month follow-up. Because Gamma Knife can manage trochlear nerve schwannomas well, surgical excision should be reserved for large ones and limited to subcapsular or subtotal removal with the expectation of possible recovery of neurologic dysfunction.
authors.affiliation: Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Shima
authors.affiliation: Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Hirai
authors.affiliation: Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Subarukai Kotoh Kinen Hospital, Higashiohmi, Shiga, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Matsuda
keywords: Gamma Knife; radiosurgery; schwannoma; trochlear nerve