Kim M, Rowed D W, Cheung G, Ang L C
Department of Radiology, Sunnybrook Health Science Centre, University of Toronto, North York, Ontario, Canada.
Neurosurgery. 1997 Jan;40(1):187-90. doi: 10.1097/00006123-199701000-00041.
We describe a rare case of an extra-axial cavernoma of the cerebellopontine angle without internal auditory canal involvement and with an unusual appearance on preoperative magnetic resonance imaging (MRI). Only three cases of cerebellopontine angle cavernomas have been previously reported, and none of these reports included preoperative MRI.
A young man presented with subacute left facial hypesthesia and chronic asymmetrical sensorineural hearing loss. MRI revealed a mass, which was isointense on T1- and T2-weighted images, with evidence of hemorrhage (methemoglobin and hemosiderin). The lesion did not enhance after the injection of gadolinium.
The lesion was removed without difficulty by a suboccipital approach, with intraoperative electrophysiological monitoring of facial and cochlear nerves. Facial paresis cleared postoperatively.
The present case suggests that the appearance of cerebelopontine angle cavernomas as revealed by MRI may be similar to that of intraparenchymal cavernomas. This is in contrast to previously reported cases of extra-axial cavernomas at other sites. Evidence of hemorrhage in an extra-axial lesion revealed by MRI suggests a possible diagnosis of cavernoma.
我们描述了一例罕见的桥小脑角轴外海绵状血管瘤，不累及内耳道，术前磁共振成像（MRI）表现异常。此前仅报道过3例桥小脑角海绵状血管瘤，且均未包含术前MRI。
一名年轻男性表现为亚急性左侧面部感觉减退和慢性不对称性感音神经性听力损失。MRI显示一个肿块，在T1加权像和T2加权像上呈等信号，有出血迹象（高铁血红蛋白和含铁血黄素）。注射钆后病变无强化。
通过枕下入路顺利切除病变，术中对面神经和听神经进行电生理监测。术后面神经麻痹症状消失。
本病例提示，MRI显示的桥小脑角海绵状血管瘤的表现可能与脑实质内海绵状血管瘤相似。这与之前报道的其他部位轴外海绵状血管瘤病例不同。MRI显示轴外病变有出血迹象提示可能诊断为海绵状血管瘤。
