·
Benign tumours
·
Arise from
Schwann cells of cranial & spinal nerve roots.
VESTIBULAR SCHWANNOMA
·
a.k.a
ACOUSTIC
NEUROMA , NEURILEMMOMA
·
Most common cerebellopontine angle tumour
.
·
Most common site of origin- (controversial!) Superior Vestibular Nerve > Inferior Vestibular Nerve >
Cochlear Nerve (rare)
·
Most
Commonly- Unilateral (95%) &
Sporadic
·
Familial forms- usually Bilateral &
associated with Neurofibromatosis-2
(NF-2) [ Acoustic neuroma is seldom seen in NF-1 & if present is
usually unilateral]
·
Slow growing tumour, with growth in 3 phases:
1.
Internal Auditory Canal
2.
Cisternal phase
3.
Brainstem compression phase
·
Histology-
On microscopic examination, tumors show a mixture of two growth patterns
·
Clinical
Features:-
§ 8th
CN involvement-
1.
Progressive
sensorineural Hearing loss (SNHL)
·
Characteristically, speech
discrimination is affected more than the pure tone hearing loss.
·
Most common & earliest symptom.
2.
Tinnitus
3.
Dizziness, Vertigo
§ 5th
CN involvement-
1.
↓sensation on one half of the face
2.
Loss of corneal reflex (sign)
§ 7th
CN involvement- facial weakness
§ Compression
& shifting of the 4th ventricle causing hydrocephalus & ↑ICT.
·
Diagnosis:-
§ Best
Investigation & Investigation of Choice:- Gadolinium Contrast MRI
·
Treatment-
§ Surgical
Excision
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