Cerebellopontine angle epidermoids presenting with contralateral symptomatology: A distinct perspective on false...

Cerebellopontine angle epidermoids (CPAE) are known to present irritative symptoms due to the adjacent tumour or compressive symptoms due to direct contact and compression by the tumour. Presentation due to contralateral structural involvement has not yet been highlighted in these cases. Our aims & objectives are to evaluate patients of CPAE presenting with contralateral symptoms and to compare this subset with patients presenting with ipsilateral symptoms. This study is a retrospective analysis of patients who underwent surgery over the last 22 years for CPAE. Several parameters were taken into consideration for assessment of above objectives. Appropriate statistical tests were applied and ap-value of less than 0.05 was considered statistically significant. A total of 105 patients were included, out of which 27 patients (25.7 %) presented with symptoms of contralateral structural involvement. The most common CN with bilateral involvement were the lower cranial nerves (n = 7, 25.9 %) and most common contralateral CN involved was CN VII (n = 6, 22.2 %). On comparison with the cohort of ipsilateral structural involvement (n = 78, 74.3 %), a comparatively lower incidence of contra-/bilateral LCN involvement (p-value 0.026), ipsi-/bilateral motor deficit (p-value < 0.00001) and contra-/bilateral brainstem structures involvement (p-value < 0.00001) was observed. It isn't uncommon for CPAE to present with contralateral symptomatology as nearly one-fourth cases of our series exhibited the same. Our research adds to the small pool of studies describing contralateral symptomatology in CPAE and is the first to describe various deficits (other than trigeminal neuralgia) with a comparative analysis.