Oculomotor nerve schwannoma

Case contributed by Dr Mark Holland

Presentation

Left third cranial nerve palsy

Patient Data

Age: 50 years
Gender: Male
MRI

A vividly enhancing nodule is in line with the oculomotor nerve, and most likely represents a schwannoma. Note the "down and out" pupil - although care should be taken when interpreting this as if the scan was performed with eyes closed, then this may merely represent discongugate gaze. 

Case Discussion

Although schwannomas most commonly affect the vestibular cochlear nerve (see acoustic schwannoma) they can involve any of the cranial nerves (except CN I and II). In this case oculomotor nerve is affected. 

Histological proof is often not available for some of these tumors as until mass effect necessitates it, resection will result in a cranial nerve palsy and in this case diplopia etc... 

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Case information

rID: 19778
Published: 11th Oct 2012
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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