Issue release date: 18.03.2025
Turkish Neurosurgery
2025 , Vol 35 , Num 2
1Post Graduate Institute of Medical Education and Research, Department of Neurosurgery, Chandigarh, India
2Post Graduate Institute of Medical Education and Research, Department of Neuroradiology, Chandigarh, India
3Post Graduate Institute of Medical Education and Research, Department of Neuroanaesthesia, Chandigarh, India DOI : 10.5137/1019-5149.JTN.45077-23.2 Trigeminal schwannomas are rare lesions centered on the trigeminal ganglion at Meckel?s cave. The complexity and morbidity of surgery for these lesions have allowed stereotactic radiosurgery (SRS) to emerge as a safe and viable option for treatment. Various other lesions at this location must alert one to consider an alternative diagnosis before upfront SRS without histopathological correlation. We present three patients with trigeminal neuropathy with imaging suggesting trigeminal schwannoma. Primary clinicians recommended primary radiosurgery to these patients based on radiological diagnosis. Upon further evaluation and clinical suspicion, we established alternate diagnoses of non-Hodgkin's lymphoma, lepromatous trigeminal nerve involvement, and Aspergillosis involving the Meckel's cave in three cases. Each patient received appropriate treatment instead of SRS. SRS is one of the treatment options for trigeminal schwannomas. No neurosurgical ailment should be treated on its face value with primary SRS, but it must be carefully evaluated on a clinicoradiological profile. Upfront, primary SRS may be counterproductive or detrimental for inflammatory or infectious pathologies, attracting complications. Keywords : Stereotactic radiosurgery, Gamma knife, Lymphoma, Aspergillosis
Corresponding author : Manjul TRIPATHI, drmanjultripathi@gmail.com
2Post Graduate Institute of Medical Education and Research, Department of Neuroradiology, Chandigarh, India
3Post Graduate Institute of Medical Education and Research, Department of Neuroanaesthesia, Chandigarh, India DOI : 10.5137/1019-5149.JTN.45077-23.2 Trigeminal schwannomas are rare lesions centered on the trigeminal ganglion at Meckel?s cave. The complexity and morbidity of surgery for these lesions have allowed stereotactic radiosurgery (SRS) to emerge as a safe and viable option for treatment. Various other lesions at this location must alert one to consider an alternative diagnosis before upfront SRS without histopathological correlation. We present three patients with trigeminal neuropathy with imaging suggesting trigeminal schwannoma. Primary clinicians recommended primary radiosurgery to these patients based on radiological diagnosis. Upon further evaluation and clinical suspicion, we established alternate diagnoses of non-Hodgkin's lymphoma, lepromatous trigeminal nerve involvement, and Aspergillosis involving the Meckel's cave in three cases. Each patient received appropriate treatment instead of SRS. SRS is one of the treatment options for trigeminal schwannomas. No neurosurgical ailment should be treated on its face value with primary SRS, but it must be carefully evaluated on a clinicoradiological profile. Upfront, primary SRS may be counterproductive or detrimental for inflammatory or infectious pathologies, attracting complications. Keywords : Stereotactic radiosurgery, Gamma knife, Lymphoma, Aspergillosis