Presentation
A 14 year old boy with right sided face numbness, headache and unsteady gait. MRI revealed a brain tumor with hydrocephalic changes and a V/P shunt was inserted.
Patient Data
Age: 14 years
Gender: Male
From the case:
Trigeminal schwannoma
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- A right cerebello-pontine angle well-defined dumble-shaped or figure-of-eight mass lesion is seen oriented along the course of the right trigeminal nerve and centered upon the right Meckle's cave. The lesion shows heterogenous predominantly hypointense T1/FLAIR and heterogeneously hyperintense T2 signal intensity with small cystic areas as well as heterogenous post-contrast enhancement. The lesion measures about 7.8 X 4.7 X 4.6 cm in its axial and cranio-caudal dimensions. The lesion is seen compressing the right pons, mid brain and the right middle cerebellar peduncle, the right cerebellum as well as the right anterior and inferior temporal lobe. It is compressing the 4th ventricle and cerebral aqueduct. No supratentorial hydrocephalus with a V/P shunt tube is seen in the left lateral ventricle’s body.The lesion is extending anteriorly into the right infratemporal fossa. Associated mild downward cerebellum tonsillar herniation is noted.
- Normal internal auditory canal on either side with no mass lesion.
- No intra-axial mass lesion or otherwise parenchymal area of signal abnormality.
- No sellar mass.
Case Discussion
Right cerebellopontine angle mass lesion; consistent with trigeminal schwannoma.
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