1. Introduction Schwannomas are the most common tumors of the peripheral nerves, originating from their support cells, the Schwann cells (Knight et al., 2007). They are relatively rare tumors, accounting for around 5% of benign soft tissue tumors in adults (Kransdorf, 1995). The main sites of concentration are the cervical plexus and the peroneal, ulnar and vagus nerves (El Sayed et al., 2020). Most lesions are solitary, asymptomatic, characterized by slow growth and malignant transformation is extremely rare (Woodruff et al., 1994). The definitive treatment for peripheral nerve schwannomas is surgery (Colreavy et al., 2000). However, as it is an intrinsic tumor of the nerve, its removal implies a risk of new neurological deficits (Siqueira et al., 2013). This fact, added to the observation that in around 60% of cases tumor growth is slow, Lubelski et al. (2022) supports conservative management with serial imaging follow-up in certain cases.If, in general, schwannomas are infrequent tumors, the occurrence of this tumor in the cervical portion of the vagus nerve is even less common and, due to its rarity, a frequent subject of case reports (Gilmer-Hill & Kline, 2000). Unlike neural sheath tumors of the extremities, vagus nerve schwannomas occur in a critical area in terms of important anatomical structures that are related to the lesion, such as the internal carotid artery (Sandler et al., 2019). If, on the one hand, this location leads to greater risks of direct injury to these important structures, on the other hand, there is a greater tendency to adopt surgical treatment even in minor and incidental lesions, reducing the morbidity of surgery.In this context, we present the case of a patient with an incidental schwannoma of the cervical portion of the vagus nerve in order to discuss whether, due to the peculiarities of the location of this lesion, early surgery in asymptomatic cases is indicated.

INTRODUCTIONTakotsubo syndrome is an acute heart disease that mimics the typical features of acute coronary syndrome (ACS) [1]. Although takotsubo syndrome has an uncertain prevalence in the general population, in women with suspected ACS, the prevalence is estimated to be around 5-6% [2]. The annual incidence is very low and is approximately 0.02% [3][4].Unlike ACS, TS is reversible and the heart often heals within four to eight changes weeks. The syndrome is characterised by transient systolic and diastolic left ventricular dysfunction with wall motion abnormalities [5][6]. This condition, which was first described by Dote et al. in Japan in 1990 [3][4], usually affects postmenopausal women who have experienced some physical or psychological stress. However, it can also occur in the absence of these triggers [1][7].The prevalence of saccular aneurysms in the general population is estimated at 3.2%. Approximately 20 to 30% of cases present in the form of multiple aneurysms [8]. Intracranial aneurysms are generally diagnosed after episodes of subarachnoid haemorrhage (SAH), which causes a high rate of morbidity and mortality [9]. Rupture of an aneurysm is believed to be responsible for 0.4 to 0.6% of all aneurysm deaths, and approximately 10% of patients die before arriving at the hospital. [10]Takotsubo syndrome is generally reported to have an incidence of 0.8-17% in patients with SAH caused by ruptured aneurysm [11]. However, this case report is relevant for the clinical and pathophysiological observation of the possible association between aneurysms of the internal carotid arteries (ICA) and TS, with the latter being able to serve as an alert for possible aneurysms and thus allow for intervention prior to disruption.

Carpal tunnel release must be preceded by complete investigation to avoid misdiagnosis and surgical complications