Trigeminal schwannoma

  • Uncommon schwannoma
  • Usually middle age patients
  • If acoustic schwanomma is also present, consider NF 2
  • Typical symptoms are trigeminal neuralgia or numbness. Can have mass effects.
  • Radiographic features
    – can have dumbbell appearance (extend into cavernous sinus & cistern)
    – Can be confined to Meckel’s cave (ganglionic), CP angle (preganglionic) or extend to cavernous sinus (postganglionic)
    – T1 normally isointense to CSF
    T2 hyperintense
    DWI/ADC often higher signal on both DWI and ADC (T2 shine
    through, not restricted diffusion)
  • Treatment: Most lesions undergo surgical resection. They are in general benign lesions, and provided complete excision is feasible, then surgery is curative.

    Meckel caveF1.large.jpg

Schematic coronal section through the posterior part of the sella turcica showing the Meckel’s cave (TC = trigeminal cave)

Meckel’s cave is situated at the posterolateral aspect of the cavernous sinus on either side of the sphenoid bone. Medial to the ganglion in Meckel’s cave is the internal carotid artery in the posterior portion of the cavernous sinus. Inferior is the motor root of the trigeminal nerve and the apex of the petrous temporal bone.




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