Neurosurgical and Clinical Relevance of Microsurgical Anatomy of Cerebellar Para Floccular Perforating Space
Journal Title: Scholarly Journal of Otolaryngology - Year 2018, Vol 1, Issue 2
Abstract
The cerebellopontine angle (CPA) is a complex, neurovascular area where neoplasms and microvascular pathologies befall. Surgical treatment within the CPA demonstrates the potential risk for ischemic complications within the brainstem and cerebellum. The etiologies of these vascular complications remain unclear, but recent anatomical studies potentially could explain the origin of these events. We reviewed the recent findings and concluded the importance in protecting the perforating vessels during surgical intervention for all pathologies within the CPA. The surgical interventions for vascular and tumoral pathologies found in the cerebellopontine angle (CPA) have potential complications of brainstem and cerebellar ischemia, and may be asymptomatic or symptomatic with devastating consequences [1-3]. The most common tumors in the CPA are the vestibular schwannomas’, meningiomas, and epidermoid cyst, but it is not uncommon to see metastasized lesions, chordomas, cholesteatoma, and hamartomas within this area [4-6]. Surgical resection of some pathologies have been associated with certain vascular complications presenting as stroke findings near the surrounding structures. Consequently, tumors of the cerebellopontine angle have been associated with variable rates of postoperative facial palsy and hearing loss. The vascular pathologies of the CPA may involve microvascular compression of the cranial nerves or aneurysms. Both pathologies have been associated in the potential ischemic complications [7-12]. It is known, that a pure anterior inferior cerebellar artery (AICA) infarct affects the lateral pons, middle cerebellar peduncle, and cerebellar flocculus, and the clinical findings of a neurological examination is remarkable for early detection of some physical presentations including; facial weakness, dysarthria, dysmetria, vertigo, ataxia, horizontal nystagmus, or hearing loss.
Authors and Affiliations
Sosa Pablo, Dujovny Manuel, Gonzales López Pablo, Pedro Moreno López, Eduardo Fernández
Keywords
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- EP ID EP599048
- DOI 10.32474/SJO.2018.01.000108
- Views 58
- Downloads 0
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