Summary
Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the cranial nerves at the brainstem in the majority of cases. Trigeminal neuralgia occurring in 3.3% of acoustic neurinomas is usually assumed to be a sign of large tumour size; if associated with small tumour size, an additional pathology, such as typical vascular compression must be suspected and has to be explored at surgery. While facial paresis will usually lead to immediate radiological diagnosis of a possible cerebellopontine angle (CPA) neoplasm, facial spasm is usually not expected to be associated with a CPA tumour. We report on clinical presentation, operative findings, surgical treatment and results in 9 cases of small acoustic neurinomas associated with trigeminal neuralgia and on 4 cases associated with hemifacial spasm. The importance of the clinical characteristics is stressed; if these are typical of a vascular compression syndrome, further exploration at the time of tumour surgery and specific treatment by vascular decompression are necessary.
Similar content being viewed by others
References
Adams RD, Victor M (1985) Diseases of the cranial nerves. In: Adams RD, Victor M (eds) Principles of neurology. McGraw-Hill, New York
Barker F, Babu R, Jannetta P, Pomonis S, Bissonnette D (1994) Trigeminal neuralgia associated with posterior fossa tumors: long-term results in 25 patients. Skull Base Surg 4 [Suppl 1]: 9
Boesen T, Moller H, Charabi S, Thomsen J, Tos M (1992) Papilledema in patients with acoustic neuromas: vestibular and other oto-neurosurgical findings. Proceedings of the First International Conference on Acoustic Neuroma Copenhagen, Denmark 1991. Kugler, Amsterdam, pp 235–238
Bullitt E, Tew JM, Boyd J (1986) Intracranial tumours in patients with facial pain. J Neurosurg 64: 865–871
Dandy WE (1934) Concerning the cause of trigeminal neuralgia. Am J Surg 24: 447–455
Gardner WJ, Miklos MV (1959) Response of trigeminal neuralgia to “decompression of sensory root”: discussion of cause of trigeminal neuralgia. JAMA 170: 1773–1776
Jannetta PJ (1967) Arterial compression of the trigeminal nerve in patients with trigeminal neuralgia. J Neurosurg 26 [Suppl]: 159–162
Kanzaki J, Ogawa K, Ikeda S (1991) Changes in clinical features of acoustic neuroma. Acta Otolaryngol [Suppl] 487: 120–124
Koenig M, Kalyan-Raman K, Sureka ON (1984) Contralateral trigeminal nerve dysfunction as a false localizing sign in acoustic neuroma: a clinical and electrophysiological study. Neurosurgery 14(3): 335–337
Lanser MJ, Jacker RK, Pitts LH (1992) Intratumoral hemorrhage and cyst expansion as causes of acute neurological deterioration in acoustic neuroma patients. Proceedings of the First International Conference on Acoustic Neuroma Copenhagen, Denmark 1991. Kugler, Amsterdam, pp 229–234
Morita A, Fukushima T, Miyazaki S, Tamagawa T, Shimizu Y, Atsuji M (1987) Management of acoustic neurinoma with preserved hearing. No Shinkei Geka 15: 821–829
Pavesi G, Macaluso GM, Tinchelli S, Medici D, Ventura P, Mancia D (1992) Presurgical electrophysiological findings in acoustic nerve tumours. Electromyogr Clin Neurophysiol 32: 119–123
Selesnick SH, Jackler RK, Pitts LW (1993) The changing clinical presentation of acoustic tumors in the MRI era. Laryngoscope 103: 431–436
Snow RB, Fraser RA (1987) Cerebellopontine angle tumor causing contralateral trigeminal neuralgia: a case report. Neurosurgery 21: 84–86
Thomsen J (1976) Cerebellopontine angle tumours, other than acoustic neuromas. A report on 34 cases. A presentation of 7 bilateral acoustic neuromas. Acta Otolaryngol 82: 106–111
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Samii, M., Matthies, C. Acoustic neurinomas associated with vascular compression syndromes. Acta neurochir 134, 148–154 (1995). https://doi.org/10.1007/BF01417682
Issue Date:
DOI: https://doi.org/10.1007/BF01417682