J Korean Neurosurg Soc.  2010 Apr;47(4):271-277.

Epidermoid Tumors in the Cerebellopontine Angle Presenting with Trigeminal Neuralgia

• Son DW
• Choi CH
• Cha SH

Abstract

OBJECTIVE
The purpose of this study is to evaluate the clinical characteristics and surgical outcome of cerebellopontine angle (CPA) epidermoids presenting with trigeminal neuralgia.
METHODS
Between 1996 and 2004, 10 patients with typical symptoms of trigeminal neuralgia were found to have cerebellopontine angle epidermoids and treated surgically at our hospital. We retrospectively analyzed the clinico-radiological records of the patients.
RESULTS
Total resection was done in 6 patients (60%). Surgical removal of tumor and microvascular decompression of the trigeminal nerve were performed simultaneously in one case. One patient died due to postoperative aseptic meningitis. The others showed total relief from pain. During follow-up, no patients experienced recurrence of their trigeminal neuralgia (TN).
CONCLUSION
The clinical features of TN from CPA epidermoids are characterized by symptom onset at a younger age compared to TN from vascular causes. In addition to removal of the tumor, the possibility of vascular compression at the root entry zone of the trigeminal nerve should be kept in mind. If it exists, a microvascular decompression (MVD) should be performed. Recurrence of tumor is rare in both total and subtotal removal cases, but long-term follow-up is required.

Keyword

Epidermoid; Cerebellopontine angle; Trigeminal neuralgia; Microvascular vascular decompression

MeSH Terms

Cerebellopontine Angle
Follow-Up Studies
Humans
Meningitis, Aseptic
Microvascular Decompression Surgery
Recurrence
Retrospective Studies
Trigeminal Nerve
Trigeminal Neuralgia