Presentation
Left sided hearing loss.
Patient Data
There is a large well-defined extra-axial mass lesion seen in the left cerebellopontine (CP) angle region, extending into the left internal auditory canal with enlargement of the ipsilateral CP angle cistern. The lesion appears heterogeneously hyperintense on the T2W and FLAIR images, hypointense on T1W images and heterogeneously enhancing on contrast administration with enhancement of the left VII - VIII nerve complexes. There is widening of the left internal auditory canal.
The lesion causes mass effect in the form of compressive buckling of the left cerebellar hemisphere, cerebellar peduncles, compressive rotation of the brain stem. The lesion causes compression and right lateral displacement of the fourth ventricle with moderate dilatation of both the lateral and the third ventricles.
Case Discussion
This case demonstrates a large left CP angle acoustic schwannoma causing compressive hydrocephalus.
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