A rare case of an extra-axial cavernous angioma in the cerebellopontine angle
A 50-year-old male presented with a four-month history of dysarthria, dysphagia, and unsteady gait. Clinical examination revealed left lower cranial nerve palsy and cerebellar signs were positive on the left side; there was no facial palsy or decreased hearing in the left ear. Contrast enhanced computed tomography (CECT) images of the brain revealed an enhancing hyperdense mass lesion in the left CPA []. Widening of the CPA was noted with minimal perilesional edema. The lesion was extra-axial in location with a lobulated surface. No calcification was evident within the lesion.\nThe retrosigmoid suboccipital approach was used to operate on the patient in the supine position with head turned to the right side and fixed to the Sugita head frame. Intraoperatively, there was a lesion of 3 × 3.5 cm size in the left CPA, which was vascular and bled when attempts were made to separate it from the surrounding structures. It was adherent to the petrous dura and a thin tail of the lesion extended into the internal auditory canal. Small vessels connecting the cavernous angioma and surrounding tissues were coagulated and divided. Total excision of the lesion was done.\nHistopathological examination of the specimen showed a lobular arrangement of dilated and congested vascular spaces lined by a single layer of endothelial cells [Figures and ]. Intervening stroma was fibrocollagenous and devoid of nervous tissue. Postoperatively, there were no complications and the patient did not have further neurological deficits. He was discharged on the seventh day after the operation. The lower cranial nerve palsy recovered significantly in three months.