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[CP angle meningioma presenting as hemifacial spasm]
S Miyazaki1, T Fukushima, A Nagai
1Department of Neurosurgery, Mitsui Memorial Hospital, Tokyo, Japan.
No Shinkei Geka. Neurological Surgery
|June 1, 1987
Summary
A rare case of cerebellopontine angle meningioma caused long-term hemifacial spasm in a 64-year-old woman. Surgical removal of the tumor led to complete resolution of hemifacial spasm, highlighting tumor-induced spasm.
Area of Science:
- Neurosurgery
- Neurology
- Oncology
Background:
- Cerebellopontine angle (CP) meningiomas are tumors that develop in the space between the cerebellum and pons.
- Hemifacial spasm is an involuntary twitching of facial muscles, often caused by compression of the facial nerve.
Observation:
- A 64-year-old woman presented with an 18-year history of left hemifacial spasm, which was the sole initial symptom for a decade.
- Preoperative CT revealed an enhancing mass in the left CP angle, later diagnosed as a meningioma originating at the rostral edge of the jugular foramen.
- The tumor compressed cranial nerves VII, VIII, IX, X, and XII, and the vertebral artery, with significant compression at the root exit zone of the VIIth nerve.
Findings:
- The meningioma was successfully removed using microsurgical techniques.
- Postoperative follow-up showed complete resolution of hemifacial spasm.
- Residual deficits included hearing loss, mild facial weakness, and slight hoarseness.
Implications:
- This case underscores the rarity of CP angle meningioma presenting solely with hemifacial spasm.
- Complete tumor resection can lead to the resolution of long-standing hemifacial spasm.
- CP angle tumors should be considered in the differential diagnosis of persistent hemifacial spasm, even without other neurological signs.