Clinical and histological expression of tumors of the pontocerebellar angle

Abstract

The cerebellopontine angle area is a virtual space located in the posterior fossa of the cranial cavity, it contains several functional anatomical structures such as the cranial nerves; the seventh pair (facial) in charge of the sensitive and motor portion of the facial musculature and taste perception in its anterior 2/3 and the eighth pair (cochlear vestibule) that is in charge of producing hearing and balance. In turn, it limits with other structures of vital importance such as the brainstem, a structure that contains several nuclei as well as the respiratory and cardiovascular center, the fourth ventricle, which is an area of ​​flow of cerebrospinal fluid towards the medulla and the cerebellum in charge of the coordination of movements and part of the balance. Although it is true that multiple tumoral and non-tumorous processes can affect these structures, it is the tumoral ones that confer greater importance due to their destructive potential of neighboring structures, expansion capacity that generates compression and establishment of seeds that can metastasize to other structures local and distant. The clinical manifestations secondary to the condition in said area will depend on the site where they begin to grow as well as their size, being that initially the most frequent clinic is tinnitus and unilateral hearing loss, imbalance and nystagmus, and later there is compromise of other cranial nerves affecting facial sensitivity, taste perception and hydrocephalus due to obstruction. For its diagnosis, it requires an adequate anatomical correlation that allows guiding imaging studies that define the structures well and allow an approach to be proposed, but it is only the histological study that gives us a final diagnosis and, as such, a prognosis.