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Nicholas S. Little, Michael K. Morgan, and Robert P. Eckstein

. This case represents the first report in the literature of an ependymoma arising from a cranial nerve. References 1. Anderson MS : Myxopapillary ependymomas presenting in the soft tissue over the sacrococcygeal region. Cancer 19 : 585 – 590 , 1966 Anderson MS: Myxopapillary ependymomas presenting in the soft tissue over the sacrococcygeal region. Cancer 19: 585–590, 1966 2. Dilorenzo N , Giuffre R , Fortuna A : Primary spinal neoplasms in childhood: analysis of 1234 published cases (including

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Alejandro Fernández Coello, Andreu Gabarrós Canals, Juan Martino Gonzalez, and Juan José Acebes Martín

). When more than 1 CN was involved, the most frequent association occurred between CNs VII and VIII ( Table 2 ). TABLE 1: Cranial nerve injury distribution CN No. of Nerves Injured olfactory 13 optic 5 oculomotor 7 trochlear 7 trigeminal 1 abducens 8 facial 11 acoustic 7 glossopharyngeal 1 vagus 1 spinal accessory 1 hypoglossal 0 total 62 TABLE 2: Multiple CN injury associations Nerve Group Affected No. of Patients VII & VIII 3 I & II 2

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Louis Rosa, Mark Carol, Roberto Bellegarrigue, and Thomas B. Ducker

T rauma to the upper cervical spine will on rare occasion produce lower cranial nerve palsies. 2, 4, 9 Case reports where these palsies have been bilateral have always included evidence of damage to the spinal cord extending as high as the cervicomedullary decussation of the motor tracts. 1, 2, 4, 8, 10 In reports where no injury to the cord or brain stem has been noted, only the sixth cranial nerve has been identified as being damaged. 5, 7 The conclusion has thus been that mild neck trauma can stretch the sixth cranial nerve without producing central

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C. Eduardo Corrales, Albert Mudry, and Robert K. Jackler

, Chavda SV : Identification of the normal jugular foramen and lower cranial nerve anatomy: contrast-enhanced 3D fast imaging employing steady-state acquisition MR imaging . AJNR Am J Neuroradiol 29 : 574 – 576 , 2008 18065504 10.3174/ajnr.A0860 7 Ellis H , Gray H , Standring S : Gray's Anatomy: The Anatomical Basis of Clinical Practice Edinburgh , Elsevier Churchill Livingstone , 2005 8 Eustachio B : Opuscula anatomica Venice , Luchinus , 1564 9 Fallopio G : Observationes anatomicae Paris , Turrisan , 1562 10 Fischbach F , Müller M

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Christopher P. Cifarelli, David J. Schlesinger, and Jason P. Sheehan

-beam radiotherapy in residual or recurrent lesions has the relative deterrents of resultant hypopituitarism, cranial neuropathies, cerebrovascular accidents, or radiation-induced tumor formation as both short-term and long-term sequelae to treatment. 3 , 8 Hence, radiosurgery has emerged as the preferred method of radiation delivery. 5 In the present study, we retrospectively examined the effects of GKS on cranial nerve dysfunction in patients with recurrent pituitary adenomas, including both functional and nonfunctional adenomas. Methods Study Design This is a

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Vasilios A. Zerris, Georg C. Noren, William A. Shucart, Jeff Rogg, and Gerhard M. Friehs

W ith traditional surgical treatments for trigeminal neuralgia the presence of vascular compression guides both the selection of the appropriate procedure and the likelihood of symptomatic improvement. Brisman, et al., 5 recently demonstrated that the presence of contact between a blood vessel and the trigeminal or fifth cranial nerve, as revealed on high-resolution MR imaging, may predict a particularly favorable response to GKS. As a result, interest has been renewed in defining imaging methods that may be used during stereotactic microradiosurgery to

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Ossama Al-Mefty, Samer Ayoubi, and Esam Gaber

schwannomas, 12, 13, 31, 35, 38, 42, 48, 49, 52 a trend that parallels that of patients with vestibular schwannomas. Consequently, the emphasis of treatment has shifted to the patient's quality of life, with the aim to recover or preserve cranial nerve function. In this report we focus on cranial nerve function and examine the eventual outcome of cranial nerve deficits, whether they are present preoperatively or develop postoperatively. Various surgical approaches have been used for the treatment of these tumors; the proper selection of the surgical approach minimizes

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Charles W. Needham, Gilles Bertrand, and S. Terence Myles

T his case of a large sphenoid wing meningioma presented hydrocephalus, foraminal impaction with tonsillar herniation, and cingulate, central-transtentorial, and uncal herniation, combined in such a sequence as to produce the unusual syndrome of multiple false localizing cranial nerve signs. Case Report This 42-year-old right-handed woman had had tinnitus, dizziness, and unsteady gait for 1 month, and occipital and posterior neck pain with intermittent, severe bifrontal headache, for 3 weeks. A week before admission she complained of progressive blurring

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Craig M. Kemper, Julio C. Rojas, and Steven Bauserman

relationship remains unclear. The treatment of neuritis ossificans has been resection to prevent further clinical deterioration, and a nerve-sparing procedure if minimal fiber loss secondary to compression is present. 2 No previous reports of neuritis ossificans affecting any cranial nerve exist in the literature. This report describes a case of histologically confirmed neuritis ossificans of the accessory nerve presenting as accessory neuropathy. The imaging features of this lesion are also described for the first time. Case Report This 25-year-old woman presented

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Edwin J. Cunningham, Rick Bond, Marc R. Mayberg, Charles P. Warlow, and Peter M. Rothwell

C arotid endarterectomy is highly beneficial in preventing stroke in patients who present with recently symptomatic severe carotid stenosis (70–99% narrowing). It is of modest benefit in patients with symptomatic moderate stenosis (50 to 69% narrowing) or severe asymptomatic stenosis. 4, 12 The main complication of surgery is stroke, 2, 13 but cranial nerve injuries can also occur. The reported frequency of cranial nerve injuries in published series of patients who have undergone CEA ranges from 3 to 23%. 1, 6–11, 14–16 In few of these series were patients