1 - Pediatric Neurosurgery Unit, Hospital Dona Estefânia, Hospitalar Universitário de Lisboa Central
2 - Neurosurgery Department, Hospitalar Universitário de Lisboa Central
3 - Pediatric Neuroradiology Unit, Hospital Dona Estefânia, Hospitalar Universitário de Lisboa Central
4 - Pediatric Neurology Department, Hospital Dona Estefânia, Hospitalar Universitário de Lisboa Central
26th biennal congress of the European Society for Pediatric Neurosurgery
Introduction: Facial colliculus syndrome comprises ipsilateral lower motor neuron pattern of facial nerve palsy, ipsilateral VI nerve palsy and, sometimes, conjugate gaze palsy due to an associated contralateral medial rectus palsy (internuclear ophtalmoplegia). This syndrome may be seen in relationship with tumors, demyelination, infection or vascular diseases that compromise facial colliculus at the dorsal pons in the floor of the fourth ventricle. Facial nerve palsy alone related to IV ventricle lesions may be defined as “half/partial facial colliculus syndrome” as the authors show in relationship with fourth ventricle epiermoid tumor.
Material and Methods: The authors describe the case of a fourteen years old girl with intermittent peripheral facial nerve palsy related to fourth ventricle epidermoid tumor and review literature.
Results: A fourteen years old girl was admitted at our institution due to left peripheral facial nerve palsy (House-Brackmann IV/VI) and headache. CT scan and MRI showed quadrigeminal cistern lipoma and IV ventricle epidermoid tumor. She recovered from facial palsy some days after admission and also from headaches and was discharged. Some weeks after was admitted again with facial nerve palsy and headache so the authors decided to remove the tumor. At surgery there was an intimate relationship between the upper part of the epidermoid tumour and left facial colliculus. The postoperative period was uneventful and there were complete recovery and no more facial palsy episodes. The authors show preoperative images, operative videos in both microscopic and endoscopic views.
Discussion: The authors consider peripheral facial nerve palsy alone as part of facial colliculus syndrome (“half/partial facial colliculus syndrome”) associated to some lesions of the fourth ventricle.
Palavras Chave: facial colliculus, epidermoid cyst, IV ventrículo