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The article discusses evolution of concepts in the management of vestibular schwannomas. It mentions that earlier, surgical management of vestibular schwannoma (VSs) was a challenging task for multiple generations of neurosurgeons. It mentions that patients with tumors were being diagnosed late in the absence of an early otological diagnosis.

Background: The changing trends in the management of vestibular schwannoma (VS) in our practice over the last two decades as well as the current status are presented here. Materials and Methods: The observations are based on the experience of 559 consecutive cases of VS operated by the first author between 1987 and 2008, 438 of which were operated by microsurgery and 139 by gamma knife radiosurgery (GKR) (18 of which were previously operated by the authors). A detailed analysis of microsurgically managed patients in two different periods (100 consecutive patients each before 1993 and 2008) were compared to see the changing trend and document current results. Results and Discussion: In the initial experience (1990s), the emphasis in microsurgery was preserving life, total excision of tumor and preservation of function in that order. In the 21st century, the emphasis in microsurgery has been all about functional preservation. In 100 consecutive cases of VS (excluding neurofibromatosis-2) that were treated microsurgically between 2005-08, there were four small tumors (<2 cm), 14 medium-sized tumors (2-3 cm) and 82 large tumors (⩾3 cm). The total excision rate was 83%. The facial nerve anatomical preservation rate was 96% and function was Grade III House-Brackmann (HB) or better in 87%. Both the total excision rate and facial function of Grade II HB or better were 100% in cases with tumor size less than three cm. Functional hearing preservation was achieved in ten cases. There was no operative mortality. Conclusion: Total excision of VS, though aimed at, is no more pursued at the cost of facial function. Moreover, microsurgery, radiosurgery and observation are all valid options in the management of VS and choosing the correct modality helps in achieving optimal outcome. [ABSTRACT FROM AUTHOR]

The article discusses the condition and nature of intracranial schwannomas of the brainstem in pediatric patients. It cites the case of a 13-year-old boy presented to the hospital due to progressive left hemiparesis, ataxia and slurring of speech. The patient's cranial computed tomography (CT) and magnetic resonance imaging (MRI) examinations reveal an intra-axial cystic lesion in midbrain and pons with obstructive hydrocephalus, resulting to intraparenchymal schwannomas diagnosis.

A 63-year-old woman presented with an extremely rare oculomotor schwannoma not associated with neurofibromatosis, manifesting as a transient diplopia and ptosis. Magnetic resonance images showed a well-enhanced mass extending from the cavernous sinus to the intraorbital region. Surgical exposure confirmed the tumor originating from the oculomotor nerve in the cavernous sinus. The intraorbital cystic part of the tumor was partially resected to preserve the oculomotor function. This is the first case of oculomotor schwannoma in the cavernous sinus with intraorbital component. [ABSTRACT FROM AUTHOR]

The article presents a case of a 45-year-old man who undergone neurosurgery for right limb burning pain for three months duration. The magnetic resonance imaging (MRI) showed a mass involving the right sciatic nerve in its proximal portion. It mentions that the histological examination of the man confirmed the diagnosis of schwannoma.

The article focuses on the case of a twenty-year-old girl experiencing decreased hearing in both her ears, change in voice, headaches and progressive ataxia for the past one year. Fundus examination revealed bilateral papilledema. Her right reflex was depressed and the sensations over the right side of her face were marginally decreased. Magnetic resonance imaging revealed that large bilateral acoustic neurinomas severely compressing the brainstem.

We report a case of cervical intramedullary cystic schwannoma associated with segmental syrinx in a young adult without evidence of neurofibromatosis. The relevant literature is reviewed. [ABSTRACT FROM AUTHOR]

Intracranial schwannoma not related to cranial nerves are unusual and rarely found in the subfrontal region. We report a case of cystic olfactory groove schwannoma in a 55-year-old male, who presented with late onset seizure without raised intracranial pressure. The tumor was excised completely. [ABSTRACT FROM AUTHOR]

Examines the benefits and limitations of the surgery of vestibular schwannomas. Prevalence of atelectasis and pneumonia; Risks for complications; Symptoms and diagnosis.