The cerebellopontine angle (CPA) is an important landmark anatomically and clinically. The most common lesions at the CPA are vestibular schwannoma, meningioma, and epidermoid. CPA tumors are mostly benign, slow-growing tumors with low potential for malignancy. Schwannomas are the primary lesion of cranial nerves involving trigeminal, facial, glossopharyngeal, vagus, and sometimes even accessory cranial nerve.
CRANIAL NERVE EXAM: The most common presenting symptoms of lesions involving the CPA include hearing loss, tinnitus, dizziness, vertigo, headaches, and gait dysfunction. Hearing loss is mostly unilateral sensorineural and is due to the involvement of the cochlear nerve. Other cranial nerve deficits, brainstem compression symptoms, and hydrocephalus can also be seen with larger tumors compressing these structures. (Lak et al, 2023)
IMAGING: The diagnosis of CPA tumors is made based on history, physical examination, audiometric and radiological evaluation. Magnetic resonance image (MRI) is the gold standard for the diagnosis of CPA tumors. High-resolution computed tomography (CT) is useful for the assessment of bony involvement.
Lak AM, Khan YS. Cerebellopontine Angle Cancer. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559116/