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Today's case is a mass at the cerebellopontine angle (CPA) with classic features of an extra-axial tumor: CSF cleft (yellow arrow), displacement of subarachnoid vessels (blue arrow), and displacement of gray matter (red arrow). In addition, there is expansion of the subarachnoid space along the skull base anterior/lateral to the mass.

Differential diagnosis of a CPA mass in an adult is schwannoma, meningioma, ependymoma, and metastasis (note that ependymoma is intra-axial). Of these, schwannoma is by far the most common at this location (90%), and this was indeed a schwannoma.

Image credit: radiologyassistant.nl

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Scientists have caught a type of immune cell invading nerve cells, discovering a possible cause of fibromyalgia in an animal model of the disease.

Fibromyalgia is characterized by chronic, widespread, and debilitating pain, thought to be triggered by a process known as central sensitization. This is where the body’s central nervous system mistakenly amplifies nerve signals passing through the brain and spinal cord, sensitizing the person to more pain in a vicious feedback loop.

But our understanding of the disease, which affects mostly women, is rapidly shifting with long overdue research, and studies have pointed toward changes in the peripheral or outer nervous system also.

A 2021 study introduced antibodies from people with fibromyalgia into mice, thereby increasing the test animals’ sensitivity to pain. The investigation’s findings made a strong case for the syndrome operating as an autoimmune disorder – or at least one where immune cells play a key role.

“Growing evidence demonstrates an intricate bidirectional interaction between immune cells and sensory neurons,” writes the research team, led by molecular and cell biologist Sara Caxaria from the Queen Mary University of London.

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