Abstract
Hypoglossal schwannomas are extremely rare tumors and are usually associated with hypoglossal dysfunction. We report a case of intracranial hypoglossal schwannoma without hypoglossal nerve paresis in a 71-year-old woman. The patient experienced headache ; computed tomography (CT) and magnetic resonance imaging revealed a cystic mass on the right side of the medulla and cerebellum. The axial CT scan, at the bone window level, showed an enlargement of the right hypoglossal canal. The size of the tumor gradually increased during the 2-year follow-up. The patient was admitted to our hospital for surgical resection of the tumor. Neurological examinations yielded unremarkable findings. Since the patient was quite old, we resected the tumor via the right lateral suboccipital approach without exposing the hypoglossal canal. The entire tumor except the intracanalicular portion was excised. After tumor resection, normal rootlets and a trunk of the hypoglossal nerve were observed. The postoperative course was uneventful, and the patient showed no hypoglossal nerve paresis. In case of hypoglossal schwannoma without hypoglossal nerve paresis, an intact trunk of the hypoglossal nerve should be identified and retained during the operation to avoid hypoglossal dysfunction. Furthermore, since complete resection of the tumor frequently leads to the development of hypoglossal nerve paresis, deliberate incomplete resection is a therapeutic option, especially in elderly patients.
