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Differenzialdiagnose von Raumforderungen im Kleinhirnbrückenwinkel

Differential diagnosis of space demands in the cerebellopontine angle

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Zusammenfassung

Die Mehrzahl der Raumforderungen im Kleinhirnbrückenwinkel liegt extraaxial. Innerhalb der Kleinhirnbrückenwinkelzisterne verlaufen wichtige Strukturen, v. a. N. trigeminus, N. facialis, N. vestibulocochlearis sowie A. cerebelli inferior anterior, A. cerebelli inferior posterior und zum Sinus petrosus führende Venen. Die häufigsten Raumforderungen im Kleinhirnbrückenwinkel sind Akustikusneurinom, Meningeom sowie vaskuläre Ektasien und Aneurysmen. Seltener sind Epidermoid und andere Schwannome sowie Metastasen, Paragangliome und Arachnoidalzysten. Intraaxial gelegene Tumoren im Bereich des Kleinhirnbrückenwinkels sind v. a. Medulloblastom, Astrozytom und Ependymom, die vorwiegend bei Kindern vorkommen, seltener Plexuspapillome. Daneben finden sich Raumforderungen, die vom Felsenbein ausgehen, wie Cholesterolgranulom, maligne Otitis media, Paragangliome und Metastasen. Zur Differenzialdiagnose sind neben den anatomischen Strukturen auch die Kenntnisse der Darstellung der verschiedenen Raumforderungen und Tumoren im Kleinhirnbrückenwinkel notwendig.

Abstract

Most of the space demands in the cerebellopontine angle lie extra-axially. Important structures run within the cisterns of the cerebellopontine angle, such as the trigeminal, facial and vestibulocochlear nerves as well as the anterior inferior and posterior inferior cerebellar arteries and the veins which lead to the petrosal sinus. The most common space demands are caused by acoustic neuromas, meningeomas, vascular ectasia and aneurysms. Less common are epidermoid and other schwannomas as well as metastases, paragangliomas and arachnoidal cysts. Intra-axial tumours in the area of the cerebellopontine angle include the medulloblastoma, astrocytoma and the ependymoma, which occurs predominantly in children, in addition to the uncommon choroid plexus papilloma. Nearby, there are also space demands around the petrous bone, such as cholesterol granuloma, malignant otitis media, paraganglioma and metastases. For differential diagnosis, an understanding of the space requirements of the tumours in the cerebellopontine angle is needed in addition to knowledge of the anatomical structures.

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Authors and Affiliations

  1. Institut für Bildgebende Diagnostik und Interventionen, Klinikum Saarbrücken gGmbH

    B. Holst & G. Brill

  2. Klinik für Diagnostische und Interventionelle Neuroradiologie, Kliniken für Radiologie, Universitätsklinikum des Saarlandes, , , Homburg, Saar

    I. Q. Grunwald &  W. Reith

  3. Klinik für Diagnostische und Interventionelle Neuroradiologie, Kliniken für Radiologie, Universitätsklinikum des Saarlandes, 66421 , Homburg, Saar

    W. Reith

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  1. B. Holst
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Correspondence to W. Reith.

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Holst, B., Grunwald, I.Q., Brill, G. et al. Differenzialdiagnose von Raumforderungen im Kleinhirnbrückenwinkel. Radiologe 44, 1113–1137 (2004). https://doi.org/10.1007/s00117-004-1131-8

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  • DOI: https://doi.org/10.1007/s00117-004-1131-8

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