Cerebellopontine angle tumor (Facial nerve neurinoma) with suspicious infarction of Anterior inferior cerebellar artery.

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A 55-year-old man had left hearing loss, left facial hypesthesia, left facial nerve palsy and loss of taste after the sudden onset of double vision and severe rotatory vertigo accompanied by nausea and vomiting. A neurosurgeon made the diagnosis of possible infarction of the anterior inferior cerebellar artery on the basis of VAG and CT test results.<BR>Vestibular function tests at our otoneurological clinic revealed a severe righting-reflex impairment, gaze nystagmus, horizontal nystagmus to the right and down-beat nystagmus. The caloric test including ice water irrigation revealed no response on the left. The audiogram revealed total deafness of the left ear. ECoG revealed normal action potentials, but ABR revealed curiously only the first wave on the left ear. We suspected that the lesion was in the vestibular and cochlear nuclei, but that the inner ear remained intact. A month after his first attack this patient complained of dysphagia. The neurological examination revealed curtain phenomenon, weakness of the gag reflex and deviation of the tongue to the left.<BR>The above otoneurological findings suggested cerebellopontine angle tumor and surgery was performed. Facial nerve neurinoma of the cerebellopontine angle was confirmed. The circular disturbance of the anterior inferior cerebellar artery and its branches to these involved nuclei were probably due to compression.
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