Presentation
Headache, tinnitus
Patient Data
The abnormal signal mass in the left cerebellopontine angle, extra-axial (with CSF cleft sign), widening the left internal auditory canal, measures approximately 27 x 37 x 28 mm, forming an 'ice cream cone sign.' It shows low signal intensity on T1W, heterogeneous high signal on T2W, scattered low intensity on HEMO, no diffusion restriction, compressing the left cerebellar hemisphere, left cerebellar peduncle, adjacent fourth ventricle, and pons. Post-contrast, it demonstrates strong, heterogeneous enhancement.
Case Discussion
This is a fairly typical case of vestibular schwannoma with a large mass effect, accompanied by calcification or hemorrhage. However, differential diagnosis should include other cerebellopontine angle tumors, such as meningioma or schwannoma of the facial nerve (cranial nerve VII).
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