Intracerebral schwannoma. Case report.

S OLITARY schwannomas comprise approximately 8% of primary intracranial tumors.a2, ~4 The tumor is rare in patients under the age of 15 years. * In children, as in adults, the acoustic nerve is the site of predilection3, 4,~ Reports in the literature consist mainly of a few isolated cases. Only an occasional case of schwannoma of other cranial nerves can be found in the literature2 ,5,~~ These are almost invariably in adults and are believed to occur virtually exclusively in neurofibromatosis. Intracranial sehwannoma involving cranial nerves other than the acoustic are unusual in childhood. ~,7 Intramedullary schwannomas of the spinal cord have been occasionally reported.S,9,11,1a In 1966 Gibson, et al., 7 published what appears to be the first recorded case of an intracerebral Schwann cell tumor. This developed in the temporal lobe of a 6-year-old boy. The present report records a parietal intracerebral Schwann cell tumor occurring in an 8-year-old white boy. A search of the literature has failed to reveal any further records of intracerebral Schwann cell tumors. Case Report This 8-year-old boy had had episodic frontal headache and vomiting for 2 years, and a grand mal seizure a few days before admission. Examination. Neurological examination was normal except for slight congestion of the optic discs. The electroencephalogram (EEG) was markedly abnormal over the right cerebral hemisphere. Radiological examination of the skull revealed suture diastasis and small foci of calcification in the central portion of the right parietal area. Isotope brain scan revealed increased activity in the right parietal region, and right common carotid angiography a 5 mm dislocation of midline vessels to the left, with more marked displacement posteriorly than anteriorly. There was diminished filling of small vessels throughout the parietal lobe. No tumor vessels were identified on standard films or subtraction studies. The findings suggested the diagnosis of a parietal lobe glioma. Operation. A parietal craniotomy revealed tense brain, with swollen flattened gyri in the parietal region. A firm mass was encountered by ventricular needle at a depth of 1