Extra-axial cavernous malformation of the cerebellopontine angle: illustrative case.

Journal of neurosurgery. Case lessons Pub Date : 2025-03-17 DOI:10.3171/CASE24528

Ashia M Hackett, Christopher O Adereti, Essam S Hashem, Lea Scherschinski, Elsa Nico, Adam T Eberle, Joelle N Hartke, Brandon M Fox, Ethan A Winkler, Joshua S Catapano, Michael T Lawton

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Abstract

Background: Extra-axial cavernous malformations (CMs) in the cerebellopontine angle (CPA) are rare, typically affect cranial nerves (CNs), and present significant therapeutic challenges. This report discusses the case of a patient with an extra-axial CM in the CPA involving the CN VII/VIII complex, alongside a systematic review of similar cases.

Observations: A literature search of the PubMed and Embase databases identified 216 articles, with 18 meeting the inclusion criteria, encompassing 21 cases (average age 42.6 years). The most common symptoms were hearing loss (86%), facial palsy (43%), and facial numbness (33%). After surgery, hearing improved in 26% of patients and facial palsy improved in 37%. Overall, 32% of patients experienced postoperative improvement. One death was reported.

Lessons: These lesions can cause significant symptoms, often leading to unfavorable clinical outcomes despite surgical intervention. Gross-total resection with CN preservation is the goal, but more data with earlier intervention and longer follow-up are needed to refine treatment strategies. https://thejns.org/doi/10.3171/CASE24528.

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桥小脑角轴外海绵状畸形：说明性病例。

背景：桥小脑角（CPA）的轴外海绵状血管瘤（CMs）非常罕见，通常影响脑神经（CNs），给治疗带来了重大挑战。本报告讨论了一例涉及CN VII/VIII复核的CPA轴外CM患者，并对类似病例进行了系统回顾。观察：PubMed和Embase数据库的文献检索确定了216篇文章，其中18篇符合纳入标准，包括21例病例（平均年龄42.6岁）。最常见的症状是听力损失（86%）、面瘫（43%）和面部麻木（33%）。手术后，26%的患者听力得到改善，37%的患者面瘫得到改善。总体而言，32%的患者术后改善。据报道有一人死亡。经验教训：这些病变可引起明显的症状，通常导致不利的临床结果，尽管手术干预。保留神经CN的全切除是目标，但需要更多的早期干预和更长的随访数据来完善治疗策略。https://thejns.org/doi/10.3171/CASE24528。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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