FN: Acoustic Neuroma/Vestibular Schwannoma

Question 1

Pathology

Answer 1

1. benign, slow-growing tumour of superior vestibular N.
2. Acts as SOL - CPA syndrome: 80% of CPA tumours
3. Association with NF2

Question 2

Presentation

Answer 2

1. slow onset, unilateral SNHL, tinnitus ± vertigo
2. Headache (raised ICP)
3. CN palsies:5,7 and 8
4. Cerebellar signs

Question 3

Investigations

Answer 3

MRI of cerebellopontine angle - MRI all pts. with unilateral tinnitus/deafness
PTA

Question 4

Differential

Answer 4

Meningioma
Cerebellar astrocytoma
Mets

Question 5

Rx

Answer 5

Gamma Knife

Surgery (risk of hearing loss)