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Acoustic neuroma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Left trigeminal neuralgia with ipsilateral hearing loss

Patient Data

Age: 55 years
Gender: Male
mri

The MRI sequences revealed a solid mass at the left cerebellopontine angle measuring (25x22x20mm), extension into an enlarged ipsilateral internal auditory canal. It is of low signal intensity on T1WI, heterogeneous high signal intensity on T2WI, and FLAIR with heterogeneous enhancement on postcontrast sequences.

A mass effect is noted on the brainstem, left middle cerebellar peduncle as well as the cisternal portion of the ipsilateral trigeminal nerve.

Case Discussion

MRI features are most consistent with an acoustic neuroma, compressing the cisternal portion of the ipsilateral trigeminal nerve.

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