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Magnified View of Right Cerebellopontine Angle with Cranial Nerves V-XII Entering their Foramina

Surgical Correlation

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Magnified view of right cerebellopontine angle with cranial nerves V-XII entering their foramina. The right cerebellum is reflected to expose the flocculus and cranial nerves emerging from the brainstem. The trigeminal nerve leaves the lateral pons and courses toward the apex of the petrous bone. The undersurface of the tentorium cerebelli is in view toward the top of the image. The facial (CNVII) and vestibulocochlear (CNVIII) nerves leave the lateral pontomedullary junction and course to the internal auditory meatus. A loop of the anterior inferior cerebellar artery is nearby. Emerging from the anterolateral surface of the medulla and traveling to the jugular foramen are, in rostral-to-caudal sequence, the glossopharyngeal (CNIX), vagus (CNX), and cranial portion of the spinal accessory (CNXI) nerves. The spinal root of the accessory nerve arises from fibers emanating from the C1-C5 levels of the spinal cord and ascends through the foramen magnum, in company with the vertebral arteries, to unite with the cranial portion within the jugular foramen. Rootlets of the hypoglossal (CNXII) nerve emerge more anteriorly from the medulla and course posterior to the vertebral artery toward the hypoglossal canal. (Image courtesy of M Nunez)

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