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Clinical Symptoms and Epidemiology of Cerebelopontine Angle Tumors
Alexander, M.Z. Arifin
NEUROSURGERY DEPARTMENT OF HASAN SADIKIN HOSPITAL/PADJADJARAN UNIVERSITY,
INDONESIA
Abstract
Background : Cerebellopontine angle ( CPA ) tumors account for 5 to 10 % of all intracranial tumors. These tumors are usually slow growing and may initially present with only subtle clinical symptoms. Early diagnosis may limit surgical morbidity and facilitate facial nerve and hearing preservation. The initial evaluation should employ a thorough clinical examination. This study is aimed to analyze the epidemiological factors and clinical appearance of these tumors.
Method: We performed a retrospective study, in which data were collected from medical records since August 2005 until August 2010 of patients that were treated in Neurosurgery department of Hasan Sadikin Hospital. The patients that match our inclusion and exclusion criteria were selected. The patients’ demographic and clinical courses were then investigated.
Result: From 418 patients registered with intracranial tumor, there were 22 cases (5,26%) of CPA tumor. Incidence of vestibular schwanoma were reported in 13 patients ( 59,09 %), CPA meningioma 5 patients ( 22,72 %), epidermoid cyst 2 patients ( 9,09 %), and arachnoid cyst 2 patients ( 9,09 % ). The age group of these tumors vary from 21 to 68 years, median age of patients with vestibular schwannoma was 40 years, meningioma was 45 years, and epidermoid cystwas 24 years. Headache was the initial symptom in 8 patients (61,54%) vestibular schwannoma and 4 patients (80%) meningioma tumors. Hearing disturbance was the initial symptom in 5 patients (38,4%) vestibular schwannoma and 1 patient (20%) meningioma tumors. Hydrocephalus was found in 4 patients (30,77%) vestibular schwannoma and 3 patient (60%) meningioma tumors. The symptoms of vestibular schwannoma tumors were hearing disturbance in 11 patients (84,6%), headache in 8 patients (61,54%), face hypestesia in 5 patients (38,46%), balance disturbance in 4 patients (30,77%), and decrease of visual acuity in 4 patients (30,77%).The symptoms of meningioma tumors were headache in 5 patients (100%), hearing disturbance in 3 patients (60%), decrease of visual acuity in 3 patients (60%), and tinitus in 2 patients (40%).
Conclusion : The incidence of CPA tumor in Hasan Sadikin Hospital was the same as recorded as in most literatures. Most of these CPA tumors was vestibular schwannoma, followed by meningioma, and epidermoid cyst. Headache and hearing disturbance was the most common initial symptom of CPA tumors. Hydrocephalus was a common presentation in late course of CPA tumor.
