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Cerebellopontine angle cyst compressing the vagus nerve: case report
Melanie G Hayden1, Stephen V Tornabene, Andy Nguyen
1Department of Neurosurgery, University of California, San Diego, San Diego, California, USA.
Neurosurgery
|June 1, 2007
Summary
A rare cerebellopontine angle (CPA) arachnoid cyst caused a 50-year-old man's vocal cord paralysis and dysphagia. Surgical decompression resolved dysphagia, highlighting CPA cysts as a cause of isolated cranial nerve palsies.
Area of Science:
- Neurology
- Neurosurgery
- Otolaryngology
Background:
- Arachnoid cysts in the cerebellopontine angle (CPA) are uncommon.
- CPA arachnoid cysts can present with varied neurological deficits depending on the structures they compress.
Observation:
- A 50-year-old male presented with sudden onset hoarseness and dysphagia.
- Otolaryngological examination revealed right vocal cord paralysis.
- Brain MRI identified a cystic mass in the right CPA, causing anterior displacement of the vagus nerve (Cranial Nerve X).
Findings:
- Surgical retrosigmoidal craniectomy with cyst fenestration was performed.
- Intraoperative findings confirmed the vagus nerve was splayed over the cyst and was decompressed.
- Postoperatively, the patient's dysphagia resolved, but dysphonia persisted with minimal vocal fold recovery.
Implications:
- This case highlights a rare presentation of a CPA arachnoid cyst causing isolated vagus nerve compression.
- CPA arachnoid cysts should be considered in the differential diagnosis of isolated cranial nerve palsies.
- Surgical cyst fenestration and nerve decompression are effective treatment options for symptomatic CPA arachnoid cysts.
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