# Unusual Surgical Resection of Asymptomatic Schwannoma of the Cervical Vagus Nerve With Risk of Stroke: Case Report

## TL;DR

A rare case of an asymptomatic cervical vagus nerve schwannoma was surgically removed due to its risk of causing a stroke.

## Contribution

This case report highlights the surgical management of a rare vagus nerve schwannoma due to stroke risk rather than symptoms.

## Key findings

- The schwannoma was asymptomatic but posed a high stroke risk due to carotid artery compression.
- Surgical removal via a transcervical approach was successful with a good patient outcome.
- Surgical indication was based on stroke risk rather than symptoms in this asymptomatic case.

## Abstract

Schwannomas are the most common tumors of the peripheral nerves, originating from their support cells, the Schwann cells. The location of the tumor in the vagus nerve is rare. Vagus schwannomas usually present as a solitary, slow-growing, asymptomatic mass that rarely causes neurological alterations. The differential diagnosis of vagus nerve schwannomas includes other tumors of the parapharyngeal space or neoplasms of the jugular foramen. We report the case of a patient with an asymptomatic schwannoma of the vagus nerve involving important neck structures, with radiological compression of the carotid artery with a high risk of stroke; because of this, we underwent surgery using a transcervical approach with intracapsular excision of the tumor. The patient has a good outcome. In asymptomatic patients' surgical indication is not an easy decision; in this case, the main reason for surgical indication was the risk of stroke with potential neurological sequels.