Evaluation of Extra Axial Cerebellopontine Angle Tumours through MRI (original) (raw)
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Non-acoustic tumors of the cerebellopontine angle
Neurosurgical Review, 1992
52 patients with non-acoustic neurinoma tumors of the cerebellopontine angle undergoing surgery over a 16 year period (1974-1989) are analyzed with regard to epidemiologic factors, presenting symptoms, neurological findings, diagnostic procedures, surgical approaches, recurrences, and longterm survival rates. Meningiomas (20 cases) and epiderrnoid tumors (16 cases) outnumber the rare tumors which exhibit wide histological variation. Trigeminal neuralgia was found as a significantly frequent sign of epidermoids. Total removal was possible in nine meningiomas (45 %), fourteen epidermoid tumors (87.5%) and 11 (69%) mostly malignant rare tumors. There were many longterm survivors in meningioma and epidermoid groups with a median follow-up period of 4.1 years. The results are compared to those reported in the literature and a brief review of reported rare tumors of the angle is presented.
Clinical features and outcomes in patients with non-acoustic cerebellopontine angle tumours
Journal of Neurology, Neurosurgery & Psychiatry, 1999
Objectives-Non-acoustic tumours of the cerebellopontine angle diVer from vestibular schwannomas in their prevalence, clinical features, operative management, and surgical outcome. These features were studied in patients presenting to the regional neuro-otological unit. Methods-A retrospective analysis of clinical notes identified 42 patients with non-acoustic tumours of the cerebellopontine angle. Data were extracted regarding presenting clinical features, histopathological data after surgical resection, surgical morbidity and mortality, and clinical outcome (mean 32 months follow up). Results-The study group comprised 25 meningiomas (60%), 12 epidermoid cysts/ cholesteatomata (28%), and five other tumours. In patients with meningiomas, symptoms diVered considerably from patients presenting with vestibular schwannomas. Cerebellar signs were present in 52% and hearing loss in only 68%. Twenty per cent of patients had hydrocephalus at the time of diagnosis. After surgical resection, normal facial nerve function was preserved in 75% of cases. In the epidermoid group, fifth, seventh, and eighth nerve deficits were present in 42%, 33%, and 66% respectively. There were no new postoperative facial palsies. There were two recurrences (17%) requiring reoperation. Overall, there were two perioperative deaths from pneumonia and meningitis. Conclusions-Patients with non-acoustic lesions of the cerebellopontine angle often present with diVerent symptoms and signs from those found in patients with schwannomas. Hearing loss is less prevalent and cerebellar signs and facial paresis are more common as presenting features. Hydrocephalus is often present in patients presenting with cerebellopontine angle meningiomas. Non-acoustic tumours can usually be resected with facial nerve preservation. (J Neurol Neurosurg Psychiatry 1999;66:768-771)
A retrospective study of cerebellopontine angle tumours: A single instituitional study
IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain
Introduction: Cerebellopontine angle (CPA) tumors are rare intracranial neoplasms that arise in the region between the cerebellum and the pons. 1 These tumors can be challenging to treat due to their complex anatomy and proximity to critical neurovascular structures. Surgical intervention is often necessary to achieve a favorable outcome. Aims and Objectives: The primary objectives of this retrospective study are to analyze the clinical and radiological characteristics of cerebellopontine angle tumors, identify pathological types, assess surgical resectability, and evaluate postoperative outcomes. Materials and Methods: The study enrolled 14 patients who underwent surgical intervention for cerebellopontine angle tumors at Armed forces medical college, Pune. A retrospective analysis was performed, considering demographic data, clinical presentations, imaging characteristics and surgical outcomes. Results: Vestibular schwannoma was the predominant tumor type with majority of tumors manifesting between third to fifth decades. Clinical manifestation included SNHL, cerebellar dysfunction, headache and sensory trigeminal dysfunction. A substantial proportion (86%) presented with no useful hearing preoperatively. Surgical outcomes indicated varying degrees of success, with total resection achieved in a subset of cases. Notably, anatomical preservation of the facial nerve was accomplished in a significant proportion of patients. Postoperative assessments, using the House Brackmann system, revealed positive facial nerve function outcomes in a substantial percentage. Complications included cerebrospinal fluid leak (14%), meningitis(7%) and lower cranial nerve paresis (7%). Conclusion: In conclusion, surgical intervention plays a crucial role in the management of cerebellopontine tumors. The choice of surgical approach should be individualized based on tumor characteristics and patient factors, with the goal of achieving maximum tumor resection while minimizing complications. Further research and advancements in surgical techniques are needed to optimize outcomes for patients with cerebellopontine tumors. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Incidental findings on magnetic resonance imaging screening for cerebellopontine angle tumours
The Journal of Laryngology & Otology, 2000
The otolaryngologist who requests magnetic resonance imaging (MRI) scans to exclude cerebellopontine angle (CPA) tumours may discover incidental pathologies. We retrospectively reviewed the results of 644 consecutive MRI screening scans with the aim of identifying findings other than CPA tumours. Two hundred and eighty-nine (45 per cent) scans featured one or more anomalies or abnormalities, including CPA tumour (23, four per cent), vascular loop (30, five per cent), basilar artery ectasia (13, two per cent), multiple high signal areas (135, 21 per cent), brain atrophy (52, eight per cent), sinus findings (56, nine per cent), middle ear/mastoid disease (34, five per cent), and a variety of other findings (39, six per cent) including clinically serious lesions (11, two per cent). The significance and management of these incidental findings is discussed. The majority were not clinically significant but the occasional presence of a serious incidental pathology should be borne in mind. ...
Cerebellopontine angle tumours: radiologic-pathologic correlation and diagnostic difficulties
Folia Neuropathologica, 2006
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Surgical Outcomes of Cerebellopontine Angle Tumors in 34 Cases
Pulse, 2016
Introduction: Cerebellopontine angle tumors are a surgical challenge to many neurosurgeons who want to operate in this space. Although most of these tumors are benign, they are a challenge because of the complex anatomy and important neurovascular structures that traverse this space. Most common cerebellopontine angle tumor is vestibular schwannoma. The management of these cases is essentially surgical. There has been a change in the surgical strategy over the years from simple intratumoral decompression to complete microsurgical excision, to radical excision with facial nerve and hearing preservation. Objectives: To study the clinical and radiological characteristics, know the pathological types and determine the surgical resectability and outcome of cerebellopontine angle tumor. Materials and Methods: It is a retrospective study done in the department of Neurosurgery, Apollo Hospitals Dhaka. 34 patients diagnosed with cerebellopontine angle tumor were recruited into the study. Results: Among 34 cases of cerebellopontine angle tumors vestibular schwannoma alone constituted 79%. Most of the tumors were large or giant tumors. Total resection was done in 25% of vestibular schwannoma and 50% of meningiomas. Anatomical preservation of facial nerve was achieved in 73% of patients. Facial nerve function as measured by the House Brackmann system. Postoperatively 61% had a score of 1 or 2; 29% had a score of 3 or 4; and 8% had a score of 5 or 6. Other complications included 2 cases of CSF leak, 3 cases of meningitis, 2 cases of lower cranial nerve palsy and 1 patient died. Conclusion: Cerebellopontine angle tumors show high incidence from 3rd to 5th decade with common symptoms being hearing loss and ataxia. Most of the patients presented at a delayed stage with large to giant tumors with no useful hearing. Sub total excision with keeping anterior part of tumor for preserving facial nerve function is the goal.
Surgical Outcome of Cerebellopontine Angle Tumors
2019
Objectives: The purpose of this study was to evaluate the clinical features and surgical outcome of CP tumors with retractorless method.Material and Methods: It is a retrospective study of 7 cases operated in Neurosurgery Unit 1, PINS/Lahore General Hospital, Lahore. Study span was 2 months and follow up duration was 15 days. Predominating symptoms were related to cranial nerves 5th, 6th, 7th, 8th and cerebellum.Results: Age range was 25 – 45 years with an average age of 35 years. 4 patients were male and 3 patients were female. In all patients, surgery was performed. Clinical presentation was tinnitus, decrease hearing, hearing loss, abnormal balance, headache, facial numbness, buccal numbness, ataxia and trigeminal neuralgia in one case. All patients were operated through retrosigmoid sub-occipital approach with retractorless method. VP shunt was inserted in 3 cases and EVD was done in all other cases just before surgery. Histopathology report was 4 patients were of vestibular sch...
Skull Base Surgery, 2008
The most common cerebellopontine angle (CPA) tumor is a vestibular schwannoma, but one in five CPA tumors are not vestibular schwannomas. These tumors may require different management strategies. Compared with vestibular schwannomas, symptoms and signs from cranial nerve VIII are less frequent: other cranial nerve and cerebellar symptoms and signs predominate in patients with these less common CPA tumors. Computed tomography and magnetic resonance imaging often show features leading to the correct diagnosis. Treatment most often includes surgery, but a policy of observation or subtotal resection is often wiser. This review provides a structured approach to the diagnosis of nonvestibular schwannoma CPA lesions and also management guidelines.
Case Reports in Neurology, 2010
Background: The simultaneous occurrence of cerebellopontine angle (CPA) meningioma and vestibular schwannoma (VS) in the absence of neurofibromatosis type 2 or history of irradiation is very rare. We report a case with coexistent CPA meningioma and VS, which were radiologically not distinguishable in preoperative imaging. Case Description: A 46-year-old female presented with acute hearing loss, tinnitus and gait ataxia. Otorhinolaryngological diagnostic workup and imaging studies showed an intra-and extrameatal homogenous contrast enhancing lesion. The neuroradiological diagnosis was VS. The patient was operated via the retrosigmoid approach. Intraoperatively two distinct tumors were found: a small, mainly intrameatally located VS and a larger meningioma originating from the dura of the petrous bone. Both tumors were completely microsurgically removed. The patient experienced no new neurological deficit after surgery; particularly facial nerve function was completely preserved. Histopathological examination revealed a fibromatous meningioma and a VS, respectively. Conclusions: The coincidental occurrence of CPA meningioma and VS is very rare. Careful interpretation of imaging studies before surgery is crucial. Even such rare cases should be kept in mind when discussing the therapeutic options with the patient. More 112 studies are needed for a better understanding of mechanisms leading to multiple tumor growth.
Cerebellopontine Angle Meningiomas: Clinical Manifestations and Diagnosis
Annals of Otology, Rhinology, and Laryngology, 1985
Cerebellopontine angle (CPA) meningiomas constitute about 1% of intracranial meningiomas. The clinical aspects of a series of 32 patients with surgically confirmed CPA meningiomas are analyzed. The most common symptoms at the time of the initial evaluation were from the eighth cranial nerve (unilateral hearing loss-24 patients, vertigo or imbalance-19 patients, tinnitus-11 patients), and the fifth cranial nerve (altered sensation-9 patients, facial pain-5 patients). On examination, the most common findings were absent caloric response (19 patients), nystagmus (16 patients), diminished facial sensation (14 patients), ataxia (13 patients), reduced hearing (9 patients), and facial weakness (9 patients). There was often a long interval from the onset of symptoms to the correct diagnosis of a tumor. Brain stem auditory evoked potentials, blink reflex testing, posterior fossa myelography, computerized tomographic scanning, and angiography were abnormal in all patients in whom the test was done, but all tests were not performed on all patients. Computerized tomographic scanning and angiography are important for definitive diagnosis and for planning surgical treatment. The histopathology of the temporal bone was studied in three patients with meningiomas in the region of the internal auditory meatus.