CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2018; 79(S 05): S407-S408
DOI: 10.1055/s-0038-1669975
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Retrosigmoid Approach for Resection of Cerebellopontine Angle Meningioma

Hussam Abou-Al-Shaar
1   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
,
Yair M. Gozal
1   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
,
Gmaan Alzhrani
1   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
,
William T. Couldwell
1   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
› Author Affiliations
Further Information

Publication History

22 May 2018

12 August 2018

Publication Date:
25 September 2018 (online)

Abstract

This video depicts the case of an 81-year-old man who presented with a 3-month history of left-sided facial numbness and gait imbalance. On examination, he had gait ataxia and decreased left facial sensation in the V2 and V3 distribution. Magnetic resonance imaging (MRI) revealed a large homogenously enhancing lesion arising from the inferior surface of the tentorium toward the left cerebellopontine angle causing significant brainstem compression ([Fig. 1A] and [1B]). The differential diagnoses for this lesion included meningioma and trigeminal nerve schwannoma. Given the patient's symptoms, the size of the lesion, and the severity of brainstem compression, surgical resection was recommended. The patient underwent a left retrosigmoid craniotomy for resection of the mass ([Fig. 2]). The patient tolerated the procedure well with no new postoperative neurological deficit. Histopathological examination of the lesion revealed a World Health Organization (WHO) grade I meningioma. Postoperative MRI was consistent with gross total resection of the tumor ([Fig. 1C] and [1D]). The patient was discharged home on postoperative day 4. At his last follow-up appointment, 1 month after surgery, the patient reported complete resolution of his imbalance and left-sided facial numbness. The patient gave consent for publication.

The link to the video can be found at: https://youtu.be/xoHmhv7bme4.