Hemiparesis: A marker of clinical aggressiveness in cerebellopontine angle epidermoid

[2] Cerebellopontine angle epidermoids frequently present with hearing loss, tinnitus, facial nerve palsy, or irritative symptoms in the form of trigeminal neuralgia or hemifacial spasm. [5] The possible explanations proposed are that large epidermoid cysts of the pineal region may cause sufficient mass effect to compress the internal capsule or cerebral peduncle resulting in weakness; the cyst may undergo malignant degeneration with the acquisition of invasive characteristics or the cyst may represent one subtype of a histologically heterogeneous mass that contains tissues of a clinically more malignant nature.