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Neurological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Hearing loss is part of normal ageing, but progressive unilateral hearing loss suggests a lesion of the vestibulocochlear (VIIIth) cranial nerve such as an acoustic neuroma; and hearing loss with facial weakness and double vision suggest a space-occupying lesion in the cerebellopontine angle, with involvement of the Vth, VIIth and VIIIth cranial nerves.
Central nervous system neoplasms
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
iii – Schwannomas are the third most common primary brain tumours in adults. The tumour marker, S-100, is an important marker for schwannomas. It is often localised to the vestibulocochlear nerve (cranial nerve VIII) at the cerebellopontine angle, in which case it is called a vestibular schwannoma or acoustic neuroma. In some cases, a schwannoma may be localised to the facial nerve (cranial nerve VII). Bilateral acoustic schwannomas can be found in neurofibromatosis type 2.10
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Cerebellopontine angle: Vestibular schwannoma compressing CN V (although CN VII is most commonly affected).Trigeminal schwannoma (second most common cause of schwannomas affecting CNs).Meningioma (multiple CNs are usually affected).Glossopharyngeal schwannoma (rare).Epidermoid/dermoid tumor.Chordoma.Chloroma.Metastases.Aberrant vessels, basilar artery ectasia, or aneurysm.
Clinical Outcomes of Minimally Invasive Corneal Neurotization After Cerebellopontine Angle Neurosurgical Procedures
Published in Current Eye Research, 2022
Yue Wu, Jiaying Zhang, Wei Ding, Gang Chen, Chunyi Shao, Jin Li, Wenjin Wang, Wei Wang
Demographic and clinical characteristics of patients underwent MICN were listed in Table 1. The mean age at the time of surgery was 32.5 ± 8.5 years. All the 12 patients had cranial tumor, and the most common type of intracranial tumor was acoustic neuroma (9 cases), cerebellar hemangioblastoma (2 cases), and meningiomas (1 case). All of them underwent cerebellopontine angle neurosurgical procedures and developed NK afterwards. The duration of all the 12 patients that had been diagnosed with NK was 3.7 ± 5.0 years at the time of MICN. All the patients suffered from facial paralysis, and therefore a tarsorrhaphy was necessary to handle eyelid retractions. According to the Mackie classification of NK, three (25%), four (33.3%), and five (41.7%) patients were respectively diagnosed with Stage I, II, and III NK.
Hearing preservation/rehabilitation surgery for small vestibular schwannoma: preliminary experience with the presigmoid retrolabyrinthine approach
Published in Acta Oto-Laryngologica, 2021
Jie Wang, Yong Li, Xingmei Wei, Jingyuan Chen, Lifang Zhang, Xinping Hao, Yongxin Li
Sporadic vestibular schwannoma (VS) is a pathological benign tumor that originates in the lateral internal acoustic canal (IAC) near Scarpa’s ganglia. It can extend medially to the cerebellopontine angle (CPA) and may compress the brainstem and cerebellum. In the early stage tumor growth causes degenerative changes to the inner ear, with nonspecific hearing loss, tinnitus, and vertigo its first clinical signs [1]. Unfortunately, VSs arise deep within the anatomical structures and consequently are rarely diagnosed before hearing loss occurs. The increasingly widespread use of otology, audiology, and magnetic resonance imaging (MRI) has, however, significantly improved the rate of early VS diagnosis with the mean tumor size at diagnosis decreasing from 30 mm to 3.0 mm [2]. Cases presenting with normal or moderately impaired hearing at diagnosis have also increased as a result of improved diagnostics.
Current perspectives on galvanic vestibular stimulation in the treatment of Parkinson’s disease
Published in Expert Review of Neurotherapeutics, 2021
Soojin Lee, Aiping Liu, Martin J. McKeown
Anatomically, the vestibular nerve combines with the cochlear nerve and becomes the vestibulocochlear nerve. Traveling by the cerebellopontine angle, this nerve enters the brainstem at the pontomedullary junction where the vestibular and cochlear nerves separate [49]. Some of the nerve fibers project to the flocculonodular lobe and nearby vermis of the cerebellum, while the majority of the fibers project to the ipsilateral vestibular complex in the pons [49]. The vestibular complex is where the vestibular inputs are primarily processed, and consists of four major nuclei including medial, lateral, superior, and inferior [50] as well as several adjacent cell groups. The vestibular pathways from the vestibular nuclei have different functional roles. Projections to the spinal cord are essential for postural reflexes to adjust head and body movements [51], and projections to the ocular motor nuclei are critical for compensatory eye movements during head motion (the vestibular-ocular reflex). Projections to the cerebellum are important for balance, postural control, and movement coordination [49], and pathways to the thalamus, hippocampus, and ultimately to the cortical areas are responsible for multisensory integration [50,52], contributing to movement planning and execution, spatial navigation and memory, attention, and emotional processing [52–54].