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Schwannoma causing greater occipital nerve neuralgia: Case report

Hitesh Verma, Arjun Dass, Surinder K. Singhal, Nitin Gupta, Amrinder Kaur.

Abstract
Schwannomas are benign tumors that originate from the Schwann cells of the nerve sheath. They can arise from any myelinated nerve. The pre-operative diagnosis of schwannoma is difficult and should be suggested by clinical features and supported by investigations based on techniques such as ultrasonography, computed tomography (CT), magnetic resonance imaging, and fine-needle aspiration cytology. Schawannomas can present with very subtle symptoms or morbid sequel. A 19-year-old male patient presented with 6 months history of swelling in the upper left side part of the neck. Local examination showed a 5 cm 3 cm single globular mass in the left suboccipital region. The contrast enhanced CT scan showed a 44 mm 46 mm 39 mm well defined heterogeneous mildly enhancing mass on the left side of the upper three cervical vertebras abutting them. The mass was excised under general anesthesia by transcervical approach. After extensive search of English literature we came across only three case reports where schwannoma of greater occipital nerve presented with neuralgia.

Key words: Greater occipital nerve (Arnold nerve), schwannoma, suboccipital



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