Surg Neurol
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Case Reports
Schwannoma of the facial nerve in the cerebellopontine angle presenting with hearing loss.
Schwannomas of the facial nerve in the cerebellopontine angle are unusual. The authors describe a 43-year-old woman with progressive hearing loss and dizziness who had a small schwannoma of the facial nerve in the cerebellopontine angle without extension into the internal auditory canal. The tumor was completely removed with preservation of facial nerve function. The diagnosis and management of facial nerve schwannomas are discussed.
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When a patient presents to the neurosurgeon with a traumatic intracerebral hematoma and has not deteriorated or developed new neurological deficit since the injury, the decision to remove the hematoma may be difficult. Of 244 patients with traumatic intracerebral hematomas, 85 were selected for intracranial pressure monitoring to assist in deciding whether surgical evacuation was indicated. None had deteriorated in conscious level or developed new neurological deficit since injury. ⋯ Intracranial pressure monitoring therefore failed to predict a late rise in intracranial pressure in 16.6% of those with low intracranial pressure initially. An analysis of computed tomography scanning and clinical features was therefore carried out to search for better predictors of the need for surgery. Our data suggest that basal cistern status, coma score, and the severity of edema surrounding the intracerebral hematoma should be used, in addition to intracranial pressure monitoring, to improve management of patients with traumatic intracerebral hematoma.