title: [Trigeminal neuralgia caused by cerebellopontine angle lipoma:a case report and review of the literature].
abstract: A 59-year-old man presented with right trigeminal neuralgia of the second branch, which had been treated with carbamazepine. The pain could not be controlled adequately because of side effects. CT and MRI revealed a 2-cm lesion in the right cerebellopontine angle. Retrosigmoid lateral suboccipital craniectomy was performed, and a soft yellowish mass was found to be associated with the 5th, 7th, and 8th cranial nerves, anterior inferior cerebellar artery, and small vessels. The lipoma was partially resected from around the root entry zone(REZ)of the 5th nerve and small vessels were coagulated around the REZ. After surgery, there was no trigeminal neuralgia, but facial numbness and cerebellar signs were noted. Postoperative MRI showed decompression of the trigeminal nerve and venous infarction in the middle cerebellar peduncle. Reviewing similar cases, we found 19 lipoma patients presenting with trigeminal neuralgia. Symptoms of involvement of other cranial nerves were also present in 11 patients, and 14 were younger than 30 years old. Of 17 surgical cases, total resection was not attempted apart from one case. Although pain relief was achieved in all surgical cases, complications developed in 11. Surgery should be performed only in patients with disabling and uncontrolled symptoms.
authors.affiliation: Department of Neurosurgery, Tokyo Women's Medical University Medical Center East.
authors.forename: Chika
authors.initials: C
authors.lastname: Yoshimura
authors.forename: Asami
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Suguru
authors.initials: S
authors.lastname: Yokosako
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Arai
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kuroi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Koseki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ohbuchi
authors.forename: Kengo
authors.initials: K
authors.lastname: Hirota
authors.forename: Shinji
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tani
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sasahara
authors.forename: Mariko
authors.initials: M
authors.lastname: Fujibayashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kasuya
mesh_terms: D002528:Cerebellar Neoplasms / Q000473:pathology; D002530:Cerebellopontine Angle / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D008067:Lipoma / Q000150:complications / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*