PMC10316202_01
Preoperative magnetic resonance axial (a) and coronal (b) T1-weighted gadolinium images showing a 35 mm homogeneously enhancing solid mass in the left cerebellopontine angle. Left vertebral angiogram lateral view showing the vascular tumor fed by the left superior cerebellar artery (c) and left common carotid angiogram lateral view also showing the vascular tumor fed by the left tentorial artery (d).
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F1
CPA extending superiorly to the tentorial notch [Figures 1a and b]. Cerebral angiogram revealed tumor staining fed by left superior cerebellar and left tentorial arteries [Figures 1c and d].
(a) Photograph demonstrating the scalp incision and craniotomy range. (b) The incision of the tentorium (asterisk) toward the free edge revealed a reddish extra-axial tumor (double asterisk) between the cerebellum (triple asterisk) and the tentorium. After confirming the presence of displaced trochlear nerve (arrow) in the deep part (c), the tumor (double asterisk) was detached while the feeding arteries from the cerebellar parenchyma (arrowheads) were coagulated (d), and the tumor was completely removed as a mass (e).
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F2
A horseshoe-shaped skin incision and temporo-suboccipital craniotomy were made with a splitting mastoidectomy [Figure 2a]. The incision of the tentorium toward the free edge revealed a reddish extra-axial tumor between the cerebellum and the tentorium [Figure 2b]. After confirming the presence of displaced trochlear nerve in the deep part [Figure 2c], the feeding arteries from the cerebellar parenchyma were coagulated [Figure 2d] and the tumor was completely removed as a mass [Figure 2e].
Postoperative axial (a) and coronal (b) T1-weighted gadolinium images confirming total excision of the tumor.
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F3
Postoperative MR imaging confirmed total excision of the tumor [Figures 3a and b] and no signs of recurrence for 8 years.