Acoustic neuroma

Case contributed by Dr Ammar Haouimi

Presentation

Right hearing loss.

Patient Data

Age: 80 years
Gender: Female
mri

Well-circumscribed extra-axial mass at the right cerebellopontine angle enlarging the porus acusticus with intracanalicular extension. It displays a low signal on T1, heterogeneous high signal on T2 and FLAIR with moderate and heterogeneous enhancement on postcontrast sequences.

A mass effect is noted on the right middle cerebellar peduncle, brainstem, 4th ventricle and the cisternal portion of the trigeminal nerve as well as the cerebellar hemisphere with mild posterior surrounding edema.

Dilatation of the 3rd and lateral ventricles with mild transependymal edema in keeping with obstructive hydrocephalus.

Age-related brain atrophy.

Case Discussion

MRI features most consistent with acoustic neuroma of right CPA compressing the middle cerebellar peduncle, brainstem, cerebellar hemisphere, cisternal portion of the trigeminal nerve, and 4th ventricle with secondary obstructive hydrocephalus.

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