Iwai Y, Yamanaka K, Nakajima H
Department of Neurosurgery, Osaka City General Hospital, Osaka.
Neurol Med Chir (Tokyo). 2001 Feb;41(2):87-9. doi: 10.2176/nmc.41.87.
A 54-year-old female and a 49-year-old female presented with complaints of hemifacial spasm. Both patients underwent surgery to remove cerebellopontine angle meningiomas. In one case, no vascular compression was observed at the root exit zone. The tumor was removed subtotally leaving residual tumor adhered to the lower cranial nerves. The hemifacial spasm disappeared immediately after the operation. The residual tumor was treated using gamma knife radiosurgery. In the other case, the root exit zone of the facial nerve was compressed by both the tumor and anterior inferior cerebellar artery and the tumor was removed totally. Postoperatively, the hemifacial spasm disappeared, but the patient suffered facial nerve paresis and deafness that was probably due to intraoperative manipulation. However, the facial nerve paresis gradually improved. Cerebellopontine angle meningioma with hemifacial spasm must be treated by surgical resection limited to preserve cranial nerve function. Subtotal removal with subsequent radiosurgery to treat the remaining tumor tissue is one option for the treatment of cerebellopontine angle meningioma.
一名54岁女性和一名49岁女性因半面痉挛前来就诊。两名患者均接受了手术以切除桥小脑角脑膜瘤。其中1例在神经根出脑区未观察到血管压迫。肿瘤次全切除，残留肿瘤附着于低位颅神经。术后半面痉挛立即消失。残留肿瘤采用伽玛刀放射外科治疗。另一例中，面神经的神经根出脑区被肿瘤和小脑前下动脉压迫，肿瘤被完全切除。术后，半面痉挛消失，但患者出现面神经麻痹和耳聋，这可能是由于术中操作所致。然而，面神经麻痹逐渐改善。伴有半面痉挛的桥小脑角脑膜瘤必须通过手术切除进行治疗，同时要注意保留颅神经功能。次全切除后再用放射外科治疗残留肿瘤组织是治疗桥小脑角脑膜瘤的一种选择。
