case_images: PMC11749726_01
case_images: (A) Computed tomography scan of the head shows a hypodense lesion in the left cerebellopontine angle. (B) and (C) Magnetic resonance imaging showing a 1.3 x 0.9 cm lesion in the left cerebellopontine angle area. The mass shows high signal intensity on T1W1 and T2W1 images. (D) The lesion is not enhanced after gadolinium administration. (E) Three-dimensional time-of-flight magnetic resonance angiography showing that the left superior cerebellar artery is adjacent to the trigeminal nerve.
case_images: medi-104-e41295-g001.jpg
case_images: PMC11749726_01_medi-104-e41295-g001.jpg
case_images: F1
case_images: Computed tomography (CT) of the head revealed the presence of a hypodense lesion in the left CPA (Fig. 1A). Brain MRI revealed a 1.3 x 0.9 cm lesion in the left CPA region (Fig. 1B-D). Head 3-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) detected the superior cerebellar artery (SCA) adjacent to the trigeminal nerve root, and the left CPA tumor was closely related to the trigeminal and auditory nerves (Fig. 1E).
case_images: Position relationship of the cerebellopontine angle lipoma, trigeminal nerve, and superior cerebellar artery, as observed under the microscope. (A) Dissection of the arachnoid revealed lipomas enveloping the facial-auditory nerve complex. (B) The trigeminal nerve (red arrow) adjacent to the lipoma. (C) The superior cerebellar artery (green arrow) pressing upon the trigeminal root.
case_images: medi-104-e41295-g002.jpg
case_images: PMC11749726_01_medi-104-e41295-g002.jpg
case_images: F2
case_images: The arachnoid tissue surrounding the trigeminal nerve was clipped to reveal the cerebral pool segment of the trigeminal nerve from the root entry zone of the trigeminal nerve to Meckel's cave. This revealed that the SCA was compressing the trigeminal nerve root from the medial measurements (Fig. 2C), whereas the CPA lipoma abutted the trigeminal nerve root on the lateral side.
case_images: (A) After removing the lipoma tissue on the side adjacent to the trigeminal nerve, Teflon felt was placed between the lipoma and the trigeminal nerve. (B) Teflon felt separates the superior cerebellar artery from the trigeminal nerve.
case_images: medi-104-e41295-g003.jpg
case_images: PMC11749726_01_medi-104-e41295-g003.jpg
case_images: F3
case_images: A Teflon felt was placed between the tumor and trigeminal nerve root (Fig. 3A) and between the trigeminal nerve root and SCA (Fig. 3B).