Images in Clinical Medicine

Acoustic Neuroma (Vestibular Schwannoma)

Gerald J. Ross, M.D., and James D. Patrizi, Jr., M.D.

N Engl J Med 1998; 339:1440November 12, 1998

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Article

Figure 1 A 27-year-old man presented with a two-week history of left sensorineural hearing loss and tinnitus. A T₁-weighted gadolinium-enhanced axial image through the posterior fossa at the level of the cerebellopontine angle shows the typical appearance of an acoustic neuroma (vestibular schwannoma). The larger, rounded portion (black arrow) represents the cisternal component of the mass, and the smaller, conical portion (white arrow) represents the intracanalicular component. The tumor was resected through a left suboccipital craniotomy. It involved both the superior and inferior vestibular nerves. The histologic diagnosis was acoustic neuroma. The patient's postoperative course was complicated by a pulmonary embolism, which required placement of an inferior vena caval filter. When the patient was last seen four months postoperatively, he was deaf in the left ear and had intermittent left-sided tinnitus.

Gerald J. Ross, M.D.
James D. Patrizi, Jr., M.D.
St. Francis Medical Center, Pittsburgh, PA 16201