However, preservation of auditory and facial nerve(especially the former) function after surgery is still a difficult problem. Owing to the narrow space of the CPA and the complex anatomical structure surrounding it, it is challenging to completely remove the cranial nerve cisternal segment CM, however, this surgery can be achieved under the current conditions of microscopic technology and electrophysiological monitoring. Based on the intraoperative observation, the lesion in our case does not appear to be accompanied by a venous anomaly (Fig. To the best of our knowledge, ours is the second case reported to date. reported the first case of CM in the cisternal segment of the eighth cranial nerve near the brainstem in 1998, which was associated with venous aneurysm. 2).ĬMs of CNs are extremely rare, leading to their diagnosis and treatment being challenging. This cerebellopontine fissure vein did not appear to be the tortuous vein seen in the preoperative digital subtraction angiography (Fig. Although the veins of the cerebellopontine fissure adjacent to the lesion were thicker, there was a glial layer between them, and no vascular branches were connected. The bulk of the lesion appeared to be located on the vestibular nerve with relatively minor involvement of the cochlear nerve structures whilst sparing the facial nerve. The angioma was successfully resected en bloc, and the microvessels feeding it were cauterized with 3 w, which was a weak power of electrocoagulation for hemostasis, so as to ensure that no heat was transmitted to the facial nerve. The lesion was dark red and comprised a large number of tortuous small thin-walled vessels mixed with old bleeding, It was well-margined with dimensions of 1.0 × 0.8 × 0.5 cm and was buried in the proximal cisternal portion of the auditory nerve. The surgeon used the brain spatula reasonably and intermittently, combined with dynamic micro traction technology to explore and treat the lesion in the CPA area.
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