Glossopharyngeal schwannoma: diagnostic and therapeutic aspects.

Among posterior fossa tumours, schwannomas arising from glossopharyngeal nerves are extremely rare, and only 39 cases of glossopharyngeal schwannomas have been described. The clinical and imaging features of glossopharyngeal schwannomas closely resemble that of acoustic schwannomas. Despite its accuracy, magnetic resonance imaging is not diagnostic of a ninth nerve schwannoma. This is because the schwannoma may be primarily localised to the cerebellopontine angle and may not cause enlargement of the jugular foramen. The diagnosis is possible only at surgery, once attachment to the ninth cranial nerve is seen. Because of the different surgical implications and management, preoperative recognition will help in determining the operative approach. We review the relevant literature and discuss the clinical presentation, radiological features and surgical findings in a 52-year-old woman with glossopharyngeal schwannoma.

Post-traumatic syringomyelia.

Progressive post-traumatic cystic syringomyelia is an uncommon and increasingly recognized cause of morbidity following spinal cord injury. We hereby report a 35-year-old gentleman who sustained wedge compression fracture of L-1 vertebral body 15 years back and had complete paraplegia with bowel/bladder involvement. The neurological deficit recovered with minimal residual motor deficits and erectile dysfunction. He presented now with increasing neurological deficits associated with pain and paresthesia. The MRI spine showed a syrinx extending from the site of injury up to the medulla. He underwent a syringo-peritoneal shunt and at followup his pain and motor functions had improved but erectile dysfunction was persisting.