The fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache pathologies, and their link to the trigeminal nerve, to a broader field of young scientists.

• Klíčová slova
• CGRP, Fifth cranial nerve, Headache, Migraine pathophysiology, Treatments, Trigeminal ganglion,
• MeSH
• bolesti hlavy metabolismus   patologie   patofyziologie   MeSH
• ganglion trigeminale metabolismus   patologie   patofyziologie   MeSH
• lidé MeSH
• mozkový kmen metabolismus   patologie   patofyziologie   MeSH
• nervus trigeminus metabolismus   patologie   patofyziologie   MeSH
• obličejová bolest metabolismus   patologie   patofyziologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• Klíčová slova
• ACOUSTIC NERVE/neoplasms *, NEURILEMMOMA/in infancy and childhood *,
• MeSH
• dítě MeSH
• elektroencefalografie * MeSH
• kojenec MeSH
• nádory kraniálních nervů * MeSH
• nádory * MeSH
• nemoci vestibulokochleárního nervu * MeSH
• nervus cochlearis * MeSH
• nervus vestibulocochlearis * MeSH
• neurilemom * MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Involvement of the central nervous system is registered in a relatively small number of patients with sarcoidosis. In this article we present two cases with various neurological symptoms that fulfill criteria for neurosarcoidosis (NS). In addition, we review the literature on NS with special attention to isolated cranial nerve involvement. METHODS AND RESULTS: First patient: Neurological examination identified multiple cranial neuropathy, moderate right-sided hemiparesis, polyradiculoneuritis of the lower limbs and positive meningeal signs. Laboratory tests showed serum and cerebrospinal fluid (CSF) inflammatory abnormalities, with increased values of the angiotensin-converting enzyme (ACE). CSF analysis also showed presence of 9 oligoclonal IgG bands. Brain and spine magnetic resonance imaging (MRI) revealed diffuse meningopathy, and focal granulomatous lesion in the body of the L5 vertebra. Lung sarcoidosis was confirmed by additional diagnostic procedures. The patient was treated with Methylprednisolone and a tapering course of oral Prednisone, which reduced the pain in the back and legs and improved the strength of the right leg. However, the other neurological deficiencies remained. After confirming lung sarcoidosis, the patient received Methotrexate in addition to Prednisone but during the following 2 years the patient's condition progressively worsened and ended in death. Second patient: Neurological findings showed weakness of the right n. oculomotorius and the right n. trochlearis, as well as the right-side face weakness. We found raised level of the ACE in serum and CSF. Thorax high-definition computed tomography (HDCTT) showed ribbon-like domains of discrete changes in the pulmonary parenchyma. MRI of the brain showed multiple white matter lesions. This patient also received Methylprednisolone followed by Prednisone, and after two months, ocular motility normalized. CONCLUSION: The diagnosis of NS is always a challenge. For this rerason definitive diagnosis requires the exclusion of other causes of neuropathy. Multiple cranial neuropathies should always arouse suspicion of NS.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozek patologie   MeSH
• nemoci centrálního nervového systému diagnóza   MeSH
• nemoci kraniálních nervů etiologie   MeSH
• počítačová rentgenová tomografie MeSH
• sarkoidóza diagnóza   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Postoperative speech impairment (POSI) and cranial nerve deficits (CND) are common complications of pediatric posterior fossa (PF) tumor surgery. Intraoperative MRI (ioMRI) has proven a useful tool in achieving gross total resection. The risk of POSI and CND with ioMRI remains unclear, making it the primary scope of this study. Additionally, we assessed whether POSI was associated with CND. METHODS: We prospectively included pediatric patients undergoing PF tumor surgery in 36 centers across 15 European countries. Neurological status and speech were assessed preoperatively and 1-4 weeks postoperatively. Surgical details, including tumor location and use of ioMRI, were recorded within 72 h of surgery. Postoperative CND were categorized as 0, 1, 2, or ≥ 3 nerves affected; POSI as habitual, reduced speech, or mutism. Proportional odds models estimated odds ratios (OR) for 1) POSI with stepwise adjustment for tumor location and age, and 2) CND with adjustment for preoperative CND and tumor location. Subgroup analyses assessed systematic differences, missing data, center-level effects, and histology adjustment. RESULTS: Of 790 primary PF tumor surgeries, 141 (18%) involved ioMRI. POSI occurred in 183/790 (23%) and postoperative CND in 213/790 (27%). POSI-risk with ioMRI showed non-significant unadjusted OR (95% CI) 0.83 (0.53;1.30); adjusted OR 0.76 (0.43;1.35). Fewer CNDs were observed with ioMRI (unadjusted OR 0.63 (0.40;1.00), adjusted OR 0.58 (0.33;0.94), p = 0.03). POSI-risk was associated with more CNDs (adjusted OR for 1 CND: 2.06 (1.15;3.68); 2 CND: 2.13 (1.02;4.42); ≥ 3 CND: 4.15 (1.98;8.70), p < 0.05). CONCLUSIONS: ioMRI was not associated with increased risk of postoperative complications in this multicenter cohort. The reduction in CND among ioMRI cases may reflect derived effects on surgical decision-making, expertise, case-load and case-mix. Results should be interpreted with caution due to limited intraoperative data. The association between POSI-risk and cumulative CND may indicate extensive brainstem involvement. Our findings highlight the need to further explore how ioMRI-guided strategies affect functional outcomes in pediatric PF tumour surgery. CLINICAL TRIALS ID: NCT02300766 (October 2014).

• Klíčová slova
• Cerebellar mutism syndrome, Cranial Nerve Deficits, Intraoperative Magnetic Resonance Imaging, Pediatric Neurosurgery, Posterior Fossa Tumor, Posterior Fossa syndrome,
• MeSH
• dítě MeSH
• infratentoriální nádory * chirurgie   MeSH
• kojenec MeSH
• lidé MeSH
• magnetická rezonanční tomografie * metody   MeSH
• mladiství MeSH
• nemoci kraniálních nervů * etiologie   epidemiologie   MeSH
• neurochirurgické výkony * škodlivé účinky   MeSH
• pooperační komplikace * epidemiologie   etiologie   MeSH
• poruchy řeči * etiologie   epidemiologie   MeSH
• předškolní dítě MeSH
• prospektivní studie MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• Geografické názvy
• Evropa MeSH

BACKGROUND: Facial nerve schwannomas can extend to the middle fossa or the cerebellopontine angle through the labyrinthine and cisternal segments of the facial nerve. The middle fossa approach (MFA) and its extensions provide a wide approach to deal with a large variety of lesions located in the middle and posterior cranial fossa junction. METHODS: We describe the MFA along with its advantages and limitations to treat a facial nerve schwannoma involving the middle and posterior cranial fossa. CONCLUSIONS: The MFA is a well-established route to surgically deal with tumors located in and around the proximal four segments of the facial nerve.

• Klíčová slova
• Middle fossa, Schwannoma, Tumor,
• MeSH
• lidé MeSH
• mostomozečkový úhel patologie   MeSH
• nádory kraniálních nervů * diagnostické zobrazování   patologie   chirurgie   MeSH
• nervus facialis diagnostické zobrazování   patologie   chirurgie   MeSH
• neurilemom * diagnostické zobrazování   patologie   chirurgie   MeSH
• zadní jáma lební patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The authors describe the case of an intraneural ganglion cyst involving a cranial nerve (V3), which was found to have a joint connection in support of an articular origin within the cranial nerves. An inferior alveolar intraneural cyst was incidentally discovered on a plain radiograph prior to edentulation. It was resected from within the mandibular canal with no joint connection perceived at surgery. Histologically, the cyst was confirmed to be an intraneural ganglion cyst. Reinterpretation of the preoperative CT scan showed the cyst arising from the temporomandibular joint. This case is consistent with the articular (synovial) theory of intraneural ganglion cysts. An anatomical explanation and potential joint connection are provided for this case as well as several other cases of intraneural cysts in the literature, and thus unifying cranial nerve involvement with accepted concepts of intraneural ganglion cyst formation and propagation.

• Klíčová slova
• MIP = maximum intensity projection, TMJ = temporomandibular joint, cranial nerve, facial, hypoglossal, intraneural cyst, intraneural ganglion, peripheral nerve, trigeminal,
• MeSH
• cystická ganglia diagnostické zobrazování   patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nemoci trojklaného nervu diagnostické zobrazování   patologie   chirurgie   MeSH
• nervus mandibularis diagnostické zobrazování   patologie   chirurgie   MeSH
• neurochirurgické výkony MeSH
• radiografie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

Oculomotor nerve schwannoma is an extremely rare tumour. Only 26 sufficiently described cases of oculomotor nerve schwannomas were found in the literature. The case of an oculomotor nerve schwannoma in a 12-year-old girl is presented. Clinical manifestations, as well as the aim for the radical resection with oculomotor function preservation are reviewed.

• MeSH
• dítě MeSH
• kraniotomie metody   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nádory kraniálních nervů diagnóza   chirurgie   MeSH
• nemoci okohybného nervu diagnóza   chirurgie   MeSH
• neurilemom diagnóza   chirurgie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

• Klíčová slova
• ACCESSORY NERVE *, ELECTROMYOGRAPHY *, FACIAL NERVE *, HYPOGLOSSAL NERVE *, NEUROMUSCULAR JUNCTION *,
• MeSH
• elektromyografie * MeSH
• hlavové nervy * MeSH
• lidé MeSH
• nervosvalové spojení * MeSH
• nervus accessorius * MeSH
• nervus facialis * MeSH
• nervus hypoglossus * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Schwannomas of the abducens nerve are extremely rare tumors affecting cavernous, cisternal or both segments of sixth cranial nerve. Clinical features and neuroradiological imagery are frequently insufficient to reach an accurate pre-operative diagnosis. We report a patient with a cystic tumor with ring-like contrast enhancement at the right anterior pontomesencephalic junction. Radical excision was performed via anterior transpetrosal approach and showed an extrinsic tumor originating from the sixth nerve. A postoperative sixth nerve palsy had disappeared completely 9 months after the surgery. The correct diagnosis of an abducens nerve schwannoma is established by the intraoperative finding of a tumor attachment to the sixth nerve and by histopathological analysis. The various differential diagnoses, the clinical and radiological features of this diagnosis and management are issues discussed in this illustrated review.

• MeSH
• chybná diagnóza prevence a kontrola   MeSH
• diferenciální diagnóza MeSH
• kraniotomie MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mozkový kmen diagnostické zobrazování   patologie   chirurgie   MeSH
• nádory kraniálních nervů diagnostické zobrazování   patologie   chirurgie   MeSH
• nádory mozkového kmene diagnóza   patofyziologie   MeSH
• nedoslýchavost etiologie   MeSH
• nemoci lícního nervu etiologie   MeSH
• nemoci nervus abducens patologie   patofyziologie   chirurgie   MeSH
• nervus abducens diagnostické zobrazování   patologie   chirurgie   MeSH
• neurilemom diagnostické zobrazování   patologie   chirurgie   MeSH
• neurochirurgické výkony MeSH
• počítačová rentgenová tomografie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

The presented paper is a review of syndromes which till recently had an obscure cause and still have attributes such as "primary" or "essential". Their common denominator is vascular compression of the roots of the appropriate cephalic nerves. The syndromes include trigeminal neuralgia, glossopharyngeal neuralgia, hemifacial spasm, some forms of tinnitus and vertigo, exceptionally toricollis. Vascular compression of the ventrolateral oblongata on the left leads to neurogenic hypertension. The author discusses the state of knowledge on the aetiology of syndromes, the clinical and laboratory research of which contributed some findings on the physiology and pathophysiology of the mentioned conditions. At the same time the authors present their own experience with the therapeutic method of syndromes--microvascular decompression.

• MeSH
• cerebrovaskulární poruchy komplikace   MeSH
• hemifaciální spazmus etiologie   terapie   MeSH
• lidé MeSH
• nemoci bloudivého nervu etiologie   terapie   MeSH
• nemoci kraniálních nervů etiologie   MeSH
• nemoci nervus glossopharyngeus etiologie   terapie   MeSH
• neuralgie trigeminu etiologie   terapie   MeSH
• pseudotumor cerebri etiologie   terapie   MeSH
• úžinové syndromy etiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH