[Cystic pontine glioma associated with von Recklinghausen's disease—report of a case]

A Saito, K Suda, M Kidooka, K Watanabe, M Matsuda, J Handa
No Shinkei Geka. Neurological Surgery 1984, 12 (10): 1173-6
Pontine gliomas have been considered to be out of indication for operative treatment. However, in case of a cystic type, evacuation of the cyst alone can possibly extend the survival time of the patient. Since the advent of high resolution CT the nature of the pontine tumor, whether cystic or solid, can be easily differentiated, and cystic ones subjected to operation will be increasing in number. We report a case of cystic pontine glioma associated with von Recklinghausen's disease. The patient showed a remarkable improvement in her neurological status after evacuation of the cyst. A 16-year-old girl was admitted to our clinic with complaints of tinnitus and hearing difficulty of the left ear, progressive gait disturbance and double vision. Neurological examination revealed a sensory disturbance on the left side of the face, left abducens palsy, left facial paresis, left deafness, left cerebellar ataxia, right hemiparesis and right hemisensory disturbance excluding the face. Signs and symptoms of increased intracranial pressure were absent. There were many cafe-au-lait spots and several subcutaneous nodules. CT scan demonstrated a cystic lesion with a mural nodule in the left cerebello-pontine angle. The patient underwent left suboccipital craniectomy, and a puncture of the cyst between the trigeminal and facial-acoustic nerves which were displaced dorsally yielded yellowish fluid. The content of the cyst was evacuated and its wall was widely opened. After the operation the patient showed a remarkable improvement in her neurological deficits only with left deafness remained unchanged. Histological examination showed anaplastic astrocytoma. She was discharged after irradiation of 5000 rads.(ABSTRACT TRUNCATED AT 250 WORDS)


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