Clemente-Luigi FD, Chiossone-Kerdel JA, Goncalves S

Language: Spanish
References: 23
Page: 66-71
PDF size: 615.47 Kb.

ABSTRACT

Pontocerebellar angle (PCA) represents 10% of cerebral occupying lesion. From variable origin, can cause diverse signs and symptoms that are usually enclosed under the name of pontocerebellar syndrome, which varies according to the affected structures en each particular case. This paper reports the case of a 28-year-old male patient, complaining of sudden right temporal headache, tinnitus, sudden hearing loss, vertigo and vomiting and right peripheral facial palsy. In physical exam patient presented with wide neurologic focalization. Thus, CT scan and MRI with gadolinium were performed, showing a small occupying lesion at the pontocerebellar angle with unusual characteristics. Surgical translaberyntine approach with exposure of internal auditory canal. Biopsy of hematic dark liquid was taken from pontocerebellar angle and a saccular vascular structure suggestive of aneurysm was found in the surgical field. A postoperatory angiography was performed without specific findings. Diagnosis of a posterior Willis circuit is suggested. Posterior Willis circuit aneurysm happens in less than 20% of the cases, being more common affected the posterior communicating branch of the internal carotid artery and less frequently branches of the basilar artery. Due to the low frequency of these entities, are usually undiagnosed. High suspicion and knowledge of differential diagnosis in atypical cases is required in order to offer adequate treatment.

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