Differenzialdiagnose von Raumforderungen im Kleinhirnbr�ckenwinkel

Abstract

Most of the space demands in the cerebellopontine angle lie extra-axially. Important structures run within the cisterns of the cerebellopontine angle, such as the trigeminal, facial and vestibulocochlear nerves as well as the anterior inferior and posterior inferior cerebellar arteries and the veins which lead to the petrosal sinus. The most common space demands are caused by acoustic neuromas, meningeomas, vascular ectasia and aneurysms. Less common are epidermoid and other schwannomas as well as metastases, paragangliomas and arachnoidal cysts. Intra-axial tumours in the area of the cerebellopontine angle include the medulloblastoma, astrocytoma and the ependymoma, which occurs predominantly in children, in addition to the uncommon choroid plexus papilloma. Nearby, there are also space demands around the petrous bone, such as cholesterol granuloma, malignant otitis media, paraganglioma and metastases. For differential diagnosis, an understanding of the space requirements of the tumours in the cerebellopontine angle is needed in addition to knowledge of the anatomical structures.

Extra-Axial Cerebello-Pontine Angle Medulloblastoma

“…1,3 The early onset of signs of cerebellar ataxia may indicate an axial origin of the tumor, while positional nistagmus may be suggestive of acoustic schwannoma. 16 The goals of surgery are to establish a histologic diagnosis, maximally resect the tumor mass, and promote resolution of hydrocephalus. 3,9,11 Postoperative radiation and chemotherapy are used to eliminate residual disease.…”