Acoustic neuroma Flashcards

1
Q

Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve), arising from the Schwann cells of the nerve sheath. Are these tumours benign or malignant?

A
  • typically benign

BUT 5-10% can develop into neoplasms, increasing risk of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve). Does this affect central or peripheral nerves?

A

Peripheral

  • Schwann cells = peripheral myelination
  • Oligodendrocytes = central myelination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve). What is the incidence of these?

1 - 10,000 cases per 100,000
2 - 1000 cases per 100,000
3 - 100 cases per 100,000
4 - 1 cases per 100,000

A

4 - 1 cases per 100,000

Affect men and women equally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve) can affect any age, but are they more common in young or older adults?

A
  • older adults

Typically 50-60 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which part of the brain do acoustic neuromas typically occur in?

1 - brainstem
2 - pons
3 - midbrain
4 - cerebellopontine angle

A

4 - cerebellopontine angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Are acoustic neuromas typically unilateral or bilateral?

A
  • unilateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acoustic neuromas are typically unilateral, but can be bilateral in what condition?

1 - neurofibromatosis type 2
2 - polycystic kidney disease (PKD)
3 - jacobsen syndrome
4 - down syndrome

A

1 - neurofibromatosis type 2

Remember 2 neuromas and its in type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acoustic neuromas can affect all of the following cranial nerves, EXCEPT which one?

1 - CN VIII (8)
2 - CN X (10)
3 - CN VII (7)
4 - CN V (5)
5 - cerebellum

A

2 - CN X (10)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acoustic neuromas typically cause unilateral hearing loss. Is this conductive or sensorineural?

A
  • sensorineural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which 2 of the following are effects of acoustic neuromas on CN 8?

1 - conductive hearing loss
2 - shuffling gait
3 - vertigo and balance issues
4 - sensorineural hearing loss and tinnitus

A

3 - vertigo and balance issues
- vestibular

4 - sensorineural hearing loss and tinnitus (unilateral)
- cochlear

CN 8 = vestibulocochlear nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which of the following are effects of acoustic neuromas on CN 5?

1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - dilated pupil
4 - pain in the face

A

4 - pain in the face

CN 5 = trigeminal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which of the following are effects of acoustic neuromas on CN 7?

1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - dilated pupil
4 - pain in the face

A

1 - numbness and facial muscle weakness

CN 7 = facial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acoustic neuromas can affect all of the following cranial nerves, 5, 7, 8 and the cerebellum. Which of the following are effects of acoustic neuromas on the cerebellum?

1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - ataxia
4 - pain in the face

A

3 - ataxia

Typically patients have a wide based gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If a patient presents and you suspect an acoustic neuroma, which of the following should you do?

1 - wait and see as they are benign
2 - refer urgently to ENT
3 - standard referral to ENT
4 - prescribe physio and NSAIDs

A

2 - refer urgently to ENT

Patients are typically monitored initially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Sensorineural hearing loss is a characteristic of acoustic neuromas. Which test is most accurate at diagnosing a sensorineural hearing loss?

1 - Rinnies test
2 - Webers test
3 - Audiometry
4 - Whispering in the patients ear

A

3 - Audiometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the gold standard imaging used to diagnose a patient with suspected acoustic neuroma?

1 - head X-ray
2 - head CT
3 - head MRI
4 - heat PET

A

3 - head MRI

Gadolinium contrast is used to enhance the image

CT may be performed as well

17
Q

Acoustic neuromas are typically treated with all of the following, EXCEPT which one?

1 - conservative watch and wait
2 - chemotherapy
3 - stereotactic radiosurgery
4 - microsurgical resection

A

2 - chemotherapy

18
Q

Acoustic neuromas are typically treated with:

  • conservative watch and wait
  • chemotherapy
  • stereotactic radiosurgery
  • microsurgical resection

Which of the following are common complications of treatment of acoustic neuromas?

1 - headache and increased ICP
2 - vision changes
3 - dizziness and hearing loss
4 - facial weakness
5 - all of the above

A

5 - all of the above

19
Q

Which of the following is NOT linked to causing tinnitus?

1 - gentamicin
2 - aspirin
3 - beta blockers
4 - NSAIDs
5 - loop diuretics

A

3 - beta blockers