The cerebellopontine angle (CPA) is a CSF-filled subarachnoid space that lies between the pons/middle cerebellar peduncle medially and dura covering the petrous temporal bone laterally. It is limited superiorly by the 5th cranial nerve and inferiorly by the 9th, 10th, and 11th cranial nerves. It is traversed by the VII and VIII cranial nerves and anterior inferior cerebellar artery (AICA). The flocculus of the cerebellum projects into the medial part of the CPA. The CPA is laterally continuous with the internal auditory canal (IAC) which extends from the porus acusticus internus to the fundus adjacent to the bony labyrinth.The most common mass lesion affecting the CPA/IAC is the vestibular schwannoma (accounting for nearly three-fourths of all such lesions). Meningioma and epidermoid are less common. Symptoms of CP/IAC lesions are usually due to cranial nerve compression such as sensorineural hearing loss (SNHL), vertigo, and trigeminal neuralgia. Large lesions can compress brainstem and/or cause hydrocephalus. Facial nerve palsy due to a CP angle mass is uncommon.

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Topographic Approach to Differential Diagnosis: Approach to Cerebellopontine Angle and Internal Acoustic Canal Pathologies

  • Harshavardhan Mahalingam

摘要

The cerebellopontine angle (CPA) is a CSF-filled subarachnoid space that lies between the pons/middle cerebellar peduncle medially and dura covering the petrous temporal bone laterally. It is limited superiorly by the 5th cranial nerve and inferiorly by the 9th, 10th, and 11th cranial nerves. It is traversed by the VII and VIII cranial nerves and anterior inferior cerebellar artery (AICA). The flocculus of the cerebellum projects into the medial part of the CPA. The CPA is laterally continuous with the internal auditory canal (IAC) which extends from the porus acusticus internus to the fundus adjacent to the bony labyrinth.The most common mass lesion affecting the CPA/IAC is the vestibular schwannoma (accounting for nearly three-fourths of all such lesions). Meningioma and epidermoid are less common. Symptoms of CP/IAC lesions are usually due to cranial nerve compression such as sensorineural hearing loss (SNHL), vertigo, and trigeminal neuralgia. Large lesions can compress brainstem and/or cause hydrocephalus. Facial nerve palsy due to a CP angle mass is uncommon.