{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:22:10Z","timestamp":1790868130578,"version":"4.1.0"},"reference-count":57,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Schwannomas occupying the craniocervical junction (CCJ) are rare and usually originate from the jugular foramen, hypoglossal nerves, and C-1 and C-2 nerves. Although they may have different origins, they may share the same symptoms, surgical approaches, and complications. An extension of these lesions along the posterior fossa cisterns, foramina, and spinal canal\u2014usually involving various cranial nerves (CNs) and the vertebral and cerebellar arteries\u2014poses a surgical challenge. The primary goals of both surgical and radiosurgical management of schwannomas in the CCJ are the preservation and restoration of function of the lower CNs, and of hearing and facial nerve function. The origins of schwannomas in the CCJ and their clinical presentation, surgical management, adjuvant stereotactic radiosurgery, and outcomes in 36 patients treated at Barrow Neurological Institute (BNI) are presented.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Between 1989 and 2009, 36 patients (mean age 43.6 years, range 17\u201368 years) with craniocervical schwannomas underwent surgical resection at BNI. The records were reviewed retrospectively regarding clinical presentation, radiographic assessment, surgical approaches, adjuvant therapies, and follow-up outcomes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Headache or neck pain was present in 72.2% of patients. Cranial nerve impairments, mainly involving the vagus nerve, were present in 14 patients (38.9%). Motor deficits were found in 27.8% of the patients. Sixteen tumors were intra- and extradural, 15 were intradural, and 5 were extradural. Gross-total resection was achieved in 25 patients (69.4%). Adjunctive radiosurgery was used in the management of residual tumor in 8 patients; tumor control was ultimately obtained in all cases.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Surgical removal, which is the treatment of choice, is curative when schwannomas in the CCJ are excised completely. The far-lateral approach and its variations are our preferred approaches for managing these lesions. Most common complications involve deficits of the lower CNs, and their early recognition and rehabilitation are needed. Stereotactic radiosurgery, an important tool for the management of these tumors as adjuvant therapy, can help decrease morbidity rates.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.5.jns0966","type":"journal-article","created":{"date-parts":[[2010,7,9]],"date-time":"2010-07-09T13:50:05Z","timestamp":1278683405000},"page":"1257-1267","source":"Crossref","is-referenced-by-count":43,"title":["Surgical management and outcome of schwannomas in the craniocervical region"],"prefix":"10.3171","volume":"114","author":[{"given":"Daniel D.","family":"Cavalcanti","sequence":"first","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay L.","family":"Martirosyan","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketan","family":"Verma","sequence":"additional","affiliation":[{"name":"Neuroscience Research Center, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Safavi-Abbasi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall W.","family":"Porter","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Theodore","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker K. H.","family":"Sonntag","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis A.","family":"Dickman","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Spetzler","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns0966","series-title":"Clin Neurol Neurosurg","first-page":"284","article-title":"Benign extramedullary tumors in the foramen magnum region","volume":"96","author":"Akalan","year":"1994"},{"key":"b2-jns0966","series-title":"J Korean Neurosurg Soc","first-page":"285","article-title":"The jugular foramen schwannomas: review of the large surgical series","volume":"44","author":"Bakar","year":"2008"},{"key":"b3-jns0966","series-title":"Neurosurgery","first-page":"617","article-title":"Hypoglossal neurilemmoma: case report and review of the literature","volume":"10","author":"Berger","year":"1982"},{"key":"b4-jns0966","series-title":"Neurosurgery","first-page":"815","article-title":"The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction","volume":"29","author":"Bertalanffy","year":"1991"},{"key":"b5-jns0966","series-title":"J Neurosurg","first-page":"794","article-title":"Microsurgical management of 53 jugular foramen schwannomas: lessons learned incorporated into a modified grading system. 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Neurosurg","first-page":"924","article-title":"Surgical treatment of jugular foramen schwannomas","volume":"82","author":"Samii","year":"1995"},{"key":"b44-jns0966","series-title":"Neurosurgery","first-page":"1086","article-title":"Surgical results for meningiomas of the craniocervical junction","volume":"39","author":"Samii","year":"1996"},{"key":"b45-jns0966","series-title":"Neurosurgery","first-page":"437","article-title":"Nonvestibular schwannomas of the brain: a 7-year experience","volume":"50","author":"Sarma","year":"2002"},{"key":"b46-jns0966","series-title":"Am J Otol","first-page":"451","article-title":"Surgical management of transcranial hypoglossal schwannomas","volume":"16","author":"Smith","year":"1995"},{"key":"b47-jns0966","series-title":"Otol Neurotol","first-page":"387","article-title":"Jugular foramen schwannoma: analysis on its origin and location","volume":"29","author":"Song","year":"2008"},{"key":"b48-jns0966","series-title":"BNI 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Analysis of 57 cases of benign extramedullary tumors","volume":"49","author":"Yasuoka","year":"1978"},{"issue":"5 Suppl","key":"b56-jns0966","series-title":"J Neurosurg","first-page":"456","article-title":"Gamma knife radiosurgery for jugular foramen schwannomas","volume":"97","author":"Zhang","year":"2002"},{"key":"b57-jns0966","series-title":"Brain Tumors: Their Biology and Pathology","author":"Zulch","year":"1965"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/5\/article-p1257.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/5\/article-p1257.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/5\/article-p1257.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T06:51:51Z","timestamp":1679899911000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/5\/article-p1257.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":57,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2010.5.jns0966","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]}}}