소뇌교각부 비청신경초종종양 환자의 임상특성과 예후분석

손동욱 ( Dong Wook Son ),최창화 ( Chang Hwa Choi ),차승헌 ( Seung Heon Cha ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.2

Non-acoustic tumours of the cerebellopontine angle differ from vestibular schwannomas in their prevalence, clinical features, operative management, and surgical outcome. The author analysed various clinical characteristics and surgical result of 24 non-acoustic tumor of cerebellopontine angle to determine their distinctive diagnostic features, the surgical difficulties and outcomes and follow-up results. Methods:A retrospective analysis of clinical notes identified 24 patients with non-acoustic tumours of the cereelopontine angle. Data were extracted regarding presenting clinical features, histopathotogical data after surgical resection, surgical morbidity and mortatity, and clinical outcome(mean 36 months follow up). Results:The study group comprised 12 meningiomas(50%), 7 epidermoid cysts(29%), 3 trigeminal schwannom, 1 primitive neuroectodermal tumor, and 1 meastatic tumor. In patients with meningiomas, symptoms differed considerably from patients presenting with vestibular schwannomas. Cerebellar signs were present in 30% and hearing loss in only 25%. After surgical resection, normal facial nerve function was preserved in 80% of cases. For the meningioma patients, the success rate of of operation(good result) was 90%, any cranial nerve deficit was combined in 10% of patient, and the mortality was 0%. In the epidermoid group, fifth, seventh, and eighth nerve deficits were present in 100%, 14%, and 14% respectively. There were no new postoperative facial palsies. There was one perioperative death from pneumonia and meningitis and the rest(85%) showed good oucome in epidermoid patient. Overall, there were no recurrences requiring reoperation. Conclusion:Patients with non-acoustic lesions of the cerebellopontine angle often present with different symptoms and signs from those found in patients with schwannomas. Hearing loss is less prevalent. Cerebellar signs and facial paresis are more common as presenting features. Non-acoustic tumours of cerebellopontine angle can usually be resected with facial nerve preservation.

A Case of Right Cerebellopontine-Angle Lesion: Psychotic Symptoms and Magnetic Resonance Imaging Findings

MinSoo Jung,ByungDae Lee,JeMin Park,YoungMin Lee,EunSoo Moon 대한신경정신의학회 2012 PSYCHIATRY INVESTIGATION Vol.9 No.3

Here, we report psychotic symptoms together with a right cerebellopontine-angle lesion. A37-year-old female patient presented with a trigeminal Schwannoma occupying the right cerebellopontine angle. Her psychotic symptoms included auditory hallucinations and delusions of persecution. T1- and T2-weighted images on magnetic resonance imaging (MRI) revealed hyperintense and hypointense areas in the right cerebellopontine angle, respectively. The clinical and neuroimaging reviews in this case suggest that sudden onset of psychotic symptoms at a mature age may be associated with a right cerebellopontine-angle lesion and that MRI should be used to evaluate possible organic bases in patients that present with psychosis.

CASE REPORT : Hemangiopericytoma of the Cerebellopontine Angle: A Wolf in Sheep`s Clothing

( Atef Ben Nsir ),( Mohamed Badri ),( Alia Zehani Kassar ),( Karim Ben Hammouda ),( Hafedh Jemel ) 대한뇌종양학회 대한신경종양학회 2016 Brain Tumor Research and Treatment Vol.4 No.1

Primary meningeal hemangiopericytoma (HPC) is a rare, aggressive dura based tumor that remarkably mimics a meningioma clinically and radiologically. Its occurrence within the cerebellopontine angle (CPA) is exceptional, and establishing the exact diagnosis is of the utmost importance since total resection remains the cornerstone of treatment. A 42-year-old man presented with a three-month history of progressively worsening vertigo and difficulty in walking. On admission, his neurological examination revealed a right peripheral facial palsy, right abducens palsy and left hemiparesis, suggesting the diagnosis of Millard-Gubler syndrome. Computed tomography and magnetic resonance imaging demonstrated a homogeneously enhancing dura based lesion of the right CPA causing major brain stem compression. There was no widening of the ipsilateral internal auditory canal. A standard retrosigmoid craniotomy was performed to access the right CPA. Exposure of the lesion revealed a well-encapsulated, gray, fibrous lesion, which appeared to originate from the tentorium. Gross total resection was achieved and confirmed radiologically. The microscopic features and the immunohistochemical profile confirmed the diagnosis of a HPC, and adjuvant radiation therapy was administered. Ten years later, the patient presented with a severe neurological deficit due to a local recurrence, but at that time refused any second intervention. He died three months later. HPC can locate within the CPA and present as a Millard-Gubler syndrome. The diagnosis should be kept in mind in case of a CPA dura based tumor. Radical surgery plus radiation therapy can maximize the recurrence-free survival and close follow-up remains mandatory to spot recurrences early.

CASE REPORT : Large Solid Hemangioblastoma in the Cerebellopontine Angle: Complete Resection Using the Transcondylar Fossa Approach

( Byung Hoo Moon ),( Sang Kyu Park ),( Young Min Han ) 대한뇌종양학회 대한신경종양학회 2014 Brain Tumor Research and Treatment Vol.2 No.2

Hemangioblastomas (HBMs) in the cerebellopontine angle (CPA) have rarely been reported. When they are within the CPA, they may be misdiagnosed as vestibular schwannoma (VS) or cystic meningioma. Therefore, differential diagnosis is important for the safe treatment of the lesion. Large solid HBMs, similar to intracranial arteriovenous malformations (AVMs), are difficult to surgically remove from an eloquent area because of their location and hypervascularity. We report a case of an HBM in the CPA, which manifested as a hearing impairment or VS. Similar to AVM surgery, the tumor was widely opened and removed en bloc without a new neurological complication using the modified transcondylar fossa approach without resection of the jugular tubercle. Accurate diagnosis, pre-operative embolization, and a tailored approach were essential for the safe treatment of the HBM in the CPA.

2형 신경섬유종증에서 양측 소뇌다리뇌각종양으로 인한 양측 전정병증

김준엽,남정무,한정호,김지수 대한신경과학회 2010 대한신경과학회지 Vol.28 No.1

Bilateral vestibulopathy (BV) is characterized by oscillopsia and imbalance during locomotion. Half of the cases of BV are idiopathic, and BV due to brain tumor has been reported only rarely. We report a case of BV due to bilateral cerebellopontine-angle tumors in a patient with neurofibromatosis type 2. Careful history on oscillopsia and imbalance during locomotion, and regular follow-ups using the head-impulse test and dynamic visual acuity are warranted in patients with neurofibromatosis type 2.

소뇌교각부 유표피낭종에 대한 임상적 고찰

이영재(Young Jae Lee),이상훈(Sang Hoon Lee),김재우(Jae Woo Kim),박강화(Kang Wha Park),강창구(Chang Koo Ghang),정의화(Ui Wha Chung),이영우(Young Woo Lee) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.1

Epidermoid tumor is rare. We reviewed 12 surgically treated intracranial epidermoid tumors of the cerebellopontine angle (CPA) between 1992 and 2005. Total resection was achieved in 11 cases (91%); in one case, some parts of the cyst capsule were left because the cyst adhered to the brainstem, vascular structure and cranial nerves from the cerebellopontine angle. The most common symptom was trigeminal neuralgia (9 cases). On their latest clinical and radiological follow-up examinations (mean 27.1months), most cases had good results without specific postoperative complications (91%). However, in one case, tumor regrowth was observed one year later and re-operation was done with a favorable result. Although epidermoid tumors in CPA are very difficult to resect totally for its surrounding neurovascular structure, a total surgical removal was possible to reduce tumor regrowth and improve outcome.

소뇌교각부에 낭종을 형성한 스팔가눔증

안철,김수천,심재홍 대한신경외과학회 1991 Journal of Korean neurosurgical society Vol.20 No.6

Sparganosis of the brain is very rare and surgical disease. Clinical experience with a case of parasitic cyst from sparganosis in cerebellopontine angle was reported with review of the literatures. A 55-year-old male had suffered from vertigo and left hearing disturbance. C-T scan revealed well demarcated cystic lesion with rim enhancement in cerebellopontine angle. Retromastoid craniectomy was performed. The parasitic cyst and adhered granuation tissues on the surrounding area were removed using surgical microscope.

Meningioma related trigeminal neuralgia presenting as odontalgia -A case report-

곽경화,이정은,한재경,황두윤,김민지,전영훈,여진석 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.2

Classical trigeminal neuralgia is characterized by recurrent attacks of lancinating pain in the trigeminal nerve distribution, and no cause of the symptoms can be identified, other than vascular compression. This type of injury may rarely be caused by identifiable conditions,including tumor in the cerebellopontine angle. If the patient is suspected for secondary trigeminal neuralgia, further evaluation is required to diagnose and treat correctly. We report a case of a 49-year-old woman with a 1-month history of facial pain, who was initially misdiagnosed as odontalgia, and even treated with the extraction of her molar teeth. This case with the review of secondary trigeminal neuralgia may highlight the difficulties of diagnosis, and the importance of early diagnostic imaging, when trigeminal neuralgia occurs with a brain tumor.

삼차신경통으로 단독 발현된 소뇌다리뇌각표피모양낭

임수환,윤보라,이진구,김용덕,나상준 대한신경과학회 2019 대한신경과학회지 Vol.37 No.4

Trigeminal neuralgia (TN) is a paroxysmal shock like pain restricted to the innervations of the areas of one or more trigeminal branches. The pathogenesis of TN is uncertain and typically is idiopathic, but it may be due to a structural lesion. Various etiologies such as vascular anomaly, tumor, infectious agents, and multiple sclerosis have been implicated as possible causes. Here we report two young patients diagnosed with trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle.

두개강내 신경초종의 출혈 : 증례 보고 Case Report

고용,김주승,이언,김대규 대한신경외과학회 1989 Journal of Korean neurosurgical society Vol.18 No.7-12

Massive hemorrgage into an intracranial neurinoma is a rare event. A 42-year old man noticed hearing loss, nystagmus, diplopia and paresthesia on the left of the face. A computerized tomography scan demonstrated a large high density mass in the left cerebellopontine angle. The tumor was successfully removed and postoperative course was favorable. Such a case of acoustic neurinoma which revealed itself through intratumoral hemorrhage has not been previously reported in Korea.