Presentation
Hearing impairment, asymmetrical sensory neural hearing loss (SNHL) and dizziness.
Patient Data
Avidly enhancing lesion is noted in the intracanalicular segment of the right internal auditory canal measuring about 12 x 4.6 mm causes minor expansion of the canal. No cerebellopontine angle component to the lesion.
Axial and corona FIESTA images a predominantly right intracanalicular mass lesion( red arrows), mostly likely schwannoma.
Axial and coronal fat-suppressed gadolinium-enhanced T1W images demonstrating avid contrast enhancement in the lesion (green arrows).
Case Discussion
The vestibulocochlear nerve is the most common intracranial nerve for schwannoma involvement. Vestibular schwannomas that originate from the IAC comprise approximately 90% of cerebellopontine angle tumors.
Contrast-enhanced MRI is the modality of choice for diagnosis of the suspected cases, and in those patients with initial changes in the hearing, to better clarify the diagnosis.
Our case according to the Koos grading scale is grade 1: intracanalicular tumor of vestibular schwannomas.
The case courtesy Dr Safwat Al Moghazi MD