Papers of the Week

Intracranial trigeminal schwannomas are rare tumors that may extend into multiple cranial compartments and may emerge from the root, ganglion or intracranial portion of any of its branches. The aim of this three-dimensional operative video is to present a single-stage complete removal of a dumbbell shaped trigeminal schwannoma through a pretemporal approach. Informed consent was given by the patient for use of images and the surgical video. We describe the case of a 43 year old female presenting with chronic headaches and left facial pain in the trigeminal territory of V2 & V3. MRI showed a tumoral lesion located within the cerebellopontine angle, petroclival region and middle fossa. Due to the patient's symptoms, tumor size and growth upon sequential imaging, single stage surgical removal was determined through a frontotemporal approach. There were no adverse outcomes posterior to the surgery and the patient evolved favorably without neurological deficits. Post-operative imaging showed complete resection of the tumoral lesion. Presurgical planning is essential for an effective and safe surgical strategy. For cases of trigeminal schwannomas with extension to the middle and posterior fossa, single stage surgery is feasible for complete and safe removal.