Acoustic neuroma

Case contributed by Dr Ammar Haouimi

Presentation

Right-sided hearing loss.

Patient Data

Age: 80 years
Gender: Male
MRI

Small well-defined right cerebellopontine angle mass with intracanalicular extension, enlarging the IAC and measuring 11 x 9 x 7 mm. It displays a low signal on T1, isosignal on T2 and FLAIR with relatively homogeneous enhancement on post-contrast sequences. No mass effect on the brainstem or middle cerebellar peduncle.

Caudal descent of the cerebellar tonsils 8 mm below the foramen magnum with no syrinx of the proximal cervical cord in keeping with Chiari 1 malformation (incidental finding).

Dilated ventricles with enlargement of the cerebral sulci in keeping with cerebral atrophy.

Chronic small vessels ischemic changes (Fazekas grade 2).

Small chronic lacunar infarct with marginal gliosis of the right caudate head.

Case Discussion

MRI features of a right CPA mass with intracanalicular extension most consistent with an acoustic neuronalChiari 1 malformation (incidental finding).

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