CASE REPORTS   

Journal of Neurosurgical Sciences 2001 June;45(2):110-3

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Trigeminal pain caused by a cerebellopontine-angle lipoma. Case report and review of the literature

Alafaci C., Salpietro F: M., Puglisi E., Tripodo E., Matalone D., Di Pietro G., Tomasello F.

Department of Neurosurgery, University of Messina, School of Medicine, Messina, Italy

A 16-­year-old ­girl com­plained of 2-­year his­to­ry of ­right ­facial ­pain, epi­sod­ic ver­ti­go and pro­gres­sive hear­ing ­loss in the ­right ear. The ­facial ­pain was ­described as an epi­sod­ic lan­ci­nat­ing ­event con­fined to the sec­ond and ­third ­branch of the ­right tri­gem­i­nal ­nerve. Computed tomog­ra­phy and mag­net­ic res­o­nance imag­ing ­revealed a 2 cm ­lesion in the ­right cer­e­bel­lo­pon­tine-­angle. At sur­gery, a ­soft, yel­low­ish ­mass was ­found incor­po­rat­ing the 7th and 8th ­cranial nerves. The ante­ri­or-infe­ri­or cer­e­bel­lar ­artery (­AICA) was dis­placed medi­al­ly and ­pushed ­into the sen­so­ry por­tion of the tri­gem­i­nal ­nerve ­root, caus­ing vas­cu­lar com­pres­sion. The hear­ing ­loss ­remained ­unchanged. The tri­gem­i­nal ­pain dis­ap­peared ­over a peri­od of sev­er­al ­weeks. Patients can be ­harmed in an ­attempt to ­remove ­these neu­ro­vas­cu­lar non­ma­lig­nant, gen­er­al­ly non grow­ing, fat­ty vas­cu­lar ­lumps. Only a par­tial, metic­u­lous remov­al ­should be per­formed ­with a max­i­mum ­effort to decom­press the affect­ed ­nerve.