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Cerebellopontine angle meningiomas

Microsurgical excision and follow-up results

Laligam N. Sekhar and Peter J. Jannetta

paper reviews the clinical features, operative findings, and the follow-up results in a series of 22 patients with cerebellopontine angle (CPA) meningiomas operated on at the University of Pittsburgh Hospitals. Clinical Material and Methods Twenty-two patients underwent operations for CPA meningiomas during the years 1974 through 1981. All patient records, operative photographs, and videotapes were reviewed. A follow-up review was obtained in all cases by clinical examination supplemented by computerized tomography (CT). Clinical Features The patient

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Masashi Fukui, Akira Tanaka, Katsutoshi Kitamura, and Toshio Okudera

I ntracranial lipoma is a rare tumor occuring most commonly in the midsagittal region. 2, 9 Except for those in the callosal area, reported cases were almost exclusively asymptomatic and were usually incidentally found at autopsy. 1, 4, 10 Reports of lipoma of the cerebellopontine angle treated surgically are extremely rare; 1 we are presenting such a case. Case Report A 28-year-old woman had had occasional bifrontal region headache for about 10 years. Not until March, 1973, did she note hearing difficulty accompanied by a feeling of obstruction and

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Tomohiro Inoue, Nobutaka Kawahara, Junji Shibahara, Tomohiko Masumoto, Kenichi Usami, and Takaaki Kirino

differential diagnosis of CPA lesions and further understanding of the tumor's pathogenesis. References 1. Eynon-Lewis NJ , Kitchen N , Scaravilli F , et al : Neurenteric cyst of the cerebellopontine angle. Case report. Neurosurgery 42 : 655 – 658 , 1998 Eynon-Lewis NJ, Kitchen N, Scaravilli F, et al: Neurenteric cyst of the cerebellopontine angle. Case report. Neurosurgery 42: 655–658, 1998 2. Ito S , Fujisawa S , Mizoi K , et al : Enterogenous cyst at the cerebellopontine angle: case

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Seong-Hyun Park, Hideyuki Kano, Ajay Niranjan, John C. Flickinger, and L. Dade Lunsford

Pittsburgh Medical Center. We excluded patients with neurofibromatosis, multiple meningiomas, those with fewer than 3 months of follow-up, and those whose prior surgical histology indicated that the tumor was atypical or anaplastic. Cerebellopontine angle meningiomas were defined as tumors whose maximal volume was centered at the anatomical junction of the lateral cerebellum, the pons, and the internal auditory meatus. The bulk of the tumor was superior to the jugular foramen and inferior to the trigeminal nerve. We did not include meningiomas that appeared to arise from

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Carlos A. Garcia, Paul A. McGarry, and Fred Rodriguez

P rimary intracranial squamous cell carcinomas are extremely rare and appear to arise from preexisting benign epidermoid cysts. Most epidermoid cysts are in the cerebellopontine angle area. They constitute 0.2% to 1.0% of all intracranial tumors. 13 They seem to develop from inclusions of embryonal ectoderm sequestered early in embryogenesis. We recently had the opportunity to study a case of a solid squamous cell carcinoma arising in the right cerebellopontine angle in an adult. The general autopsy failed to reveal a primary focus. Electron microscopy

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Hillier L. Baker Jr.

P osterior fossa myelography was designed to demonstrate lesions of the craniospinal junction and in the cerebellopontine angle cisterns. The first descriptions of the technique in 1958–1960 involved two separate examinations. 12–15 We combined both examinations in a modified form and reported our early experience in 1963. 1 Today, posterior fossa myelography is used principally for evaluating the cerebellopontine angles when the presence of an acoustic neurilemoma is suspected. 2–9, 17–27 This report summarizes our experience with posterior fossa

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Tsuyoshi Matsumoto, Eiichi Tani, Yukio Maeda, and Shigeatsu Natsume

S o-called “tumor forming” masses of amyloid, or amyloidomas, have been found in bone, brain, breast, eyelids, Gasserian ganglia, larynx, lungs, lymph nodes, orbit, pituitary gland, skin, stomach, and urinary tract. 1–4, 6, 8, 10–17, 20, 22–24, 27–29 In this report we present a patient with large amyloidomas in the left cerebellopontine angle and jugular foramen. Case Report This 47-year-old man was admitted on November 21, 1977, because of a gradual deterioration of hearing in the left ear for 15 years, hoarseness for 5 years, and left hemifacial spasm

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Christopher S. Ogilvy and Robert G. Ojemann

A ccess to the cerebellopontine angle has traditionally been gained by permanent bone removal in the superior lateral suboccipital region. 1–3 While bone removal allows an excellent view of the surgical field, it leaves this area of the brain and dura covered only by the muscle layers and the scalp. Yaşargil and Fox 4 described a technique using hand-held instruments to remove a posterior fossa bone flap, which could be replaced at the conclusion of the operative procedure. With improved high-speed drill instrumentation, we have developed a method for bone

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Madjid Samii, Marcos Tatagiba, Jose Piquer, and Gustavo A. Carvalho

E pidermoid cysts have been described as the most frequent tumorous malformation of the central nervous system. 17 They are nonneoplastic cysts that comprise approximately 1% of all intracranial space-occupying lesions. 17, 18, 29, 33 The most common site is the cerebellopontine angle (CPA), where epidermoid cysts account for 4.6% to 6.3 % of space-occupying lesions. 43 Epidermoid cysts in the CPA, which spread along the cisterns of the posterior fossa, may intimately involve multiple cranial nerves and vascular structures and may be densely adherent to

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Takanori Fukushima

means of a myeloscope. Arch Neurol Psychiatry 39: 1308–1312, 1938 16. Prott W : Cisternoscopy-endoscopy of the cerebellopontine angle. Acta Neurochir 31 : 105 – 113 , 1974 Prott W: Cisternoscopy-endoscopy of the cerebellopontine angle. Acta Neurochir 31: 105–113, 1974 17. Putnam TJ : Treatment of hydrocephalus by endoscopic coagulation of the choroid plexus. Description of a new instrument and preliminary report of results. N Engl J Med 210 : 1373 – 1376 , 1934 Putnam TJ: Treatment of