Presentation
Young adult male presented with vertigo, tinnitus and cerebellar symptoms.
Patient Data
Large well defined extra-axial heterogeneously enhancing mass in the left cerebellopontine angle with extension into the left internal auditory meatus with resultant widening.
The mass is heterogeneosly hypointense on T1W, hyperintense on T2W and FLAIR sequences.
Few tiny foci of blooming on gradient echo sequence suggestive of hemorrhage.
Multiple non-enhancing cystic necrotic areas are seen within the tumor.
The lesion is compressing and displaceing the adjacent left cerebellar hemisphere, pons, medulla and fourth ventricle with CSF/vascular "cleft" (cleft sign).
No perilesional edema is seen.
Imaging findings are suggestive of acoustic schwannoma.
Case Discussion
Acoustic schwannoma is the most common cerebellopontine angle tumor.The most common presenting symptoms include; sensorineural hearing loss, tinnitus and vertigo. Contrast enhaced MRI is the investigation of choice for such lesions.
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