Description
A 48-year-old woman presented with 8 months of right-sided burning facial pain and 4 weeks of unsteadiness. She had reduced right facial sensation and corneal reflex. She had no pyramidal or cerebellar signs. Examination of the other cranial nerves was unremarkable. She had reduced sensation in all modalities along the left side of her body.
MRI showed a right-sided enhancing cerebellopontine angle lesion indenting the mid-pons contiguous with a thickened trigeminal nerve extending towards Meckel's cave (figure 1A) with subtle enhancement of the vermis and posterior pons. There was also oedema of the pons (figure 1B). Whole-body CT and PET were unremarkable.
Figure 1
MRI brain. (A) T1-weighted post-gadolinium. (B) T2-weighted image.
A benign pathology such as trigeminal schwannoma or meningioma of the cerebellopontine angle was considered. Therefore, subtotal resection was performed to decompress the pons for symptomatic relief.
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