Acoustic Neuroma Left CP angle
67 yr ,F ,she felt dizzy and fell down on 5th october while working in the kitchen.No head ache,no vomiting ,no motor or sensory symptoms. With the help she got up ,vomited once. Evaluated locally diagnosed to have hypoglycemia Known Diabetic on oral med . Since 2 yrs she has progressive hearing loss ,evaluated before on a few occassions. Examination- Vitals stable,BP 140/ 80 mmhg . Normal higher functions and optic fundi. Intact ocular movements with gaze evoked nystagmus more prominent on the left side.5th 7th cranial nerves normal Sensory neural deafness left side.Normal other cranial nerves. Motor system gr 5/ 5 power DTRS equal bilaterally. Mild random walking abnormality ,tendency to sway to left.Alreadt ref the case to the Neurosurgeon. Surgery is fixed for 13th oct. What abnormality in the MRI? What is the diagnosis?.
Thanks for the answers. All of you are given the appropriate answers. Thanks to all once again. MRI findings: A well defind ,smoothly lobulated solid heterogeneous extra axial lesion in the left CP angle region with an intra- canalicular component extending in to the ipsilateral internal dietary canal, widening it showing multiple areas of blooming and few cystic areas with in causing significant mass effecting the form of compression,rotation and displacement of brainstem,effacement of ipsilateral cerebellar folia & 4th ventricle.Mild preeminence of 3red and lateral ventricles . Imp Acoustic Neuroma. Surgery done .
Thanks for the answers. All of you are given the appropriate answers. Thanks to all once again. MRI findings: A well defind ,smoothly lobulated solid heterogeneous extra axial lesion in the left CP angle region with an intra- canalicular component extending in to the ipsilateral internal dietary canal, widening it showing multiple areas of blooming and few cystic areas with in causing significant mass effecting the form of compression,rotation and displacement of brainstem,effacement of ipsilateral cerebellar folia & 4th ventricle.Mild preeminence of 3red and lateral ventricles . Imp Acoustic Neuroma. Surgery done .
Well defined mass at left CP angle with T1 hypointense, T2 iso/hype intense with significant mass effect and compression on adjacent structure Most common mass at cp angle is acoustic neuroma, f/b meningioma
Mam you have mentioned same history and examination for other case also (diffuse hemmorrhage SAH case). Thought this is left CP angle mass lesion with midline shift and mass effect...needs surgery
Schawanomas tumor Mostly benign Opinion of neurosurgeon
SOL in left cerebello Pontine angle.vestibular neuroma should be considered
Left Acoustic neuroma(Vestibular neuroma)
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New Case 45Yr ,F, Vertigo subjective with progressive hearing loss 2 yrs,Rt sided facial numbness 1 yr with tendency to sway to Rt side since 6 months. Evaluated by physician,ENT team on a few occassions. On exam Bp120/80 mmhg,optic fundi normal ,rt sided facial dulling of sensation ,rt sided early LMN facial weakness,rt sensoryneural deafness with rt sided cerebellar signs.MR brain done pt was ref to Neurosurgeon.
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New case 38 yr,M, Attended the OPD on 16th OCt with intermittent vertigo with occassional left temporal head ache since 3 months. On 15 th oct while climbing down the stairs after his office work he developed mild subjective vertigo with weakness of Rt lower limb ,his foot wear fell down and was unable to put it back. He sat down in the stair. Immediately felt numbness in the rt leg and he scratched the leg ,unable appreciate the sensation . With in 20 mts he regained the leg power, the numbness disappeared,he drew the vehicle and arrived home safely. The vertigo was subjective with out nausia or vomiting ,each episode for less than 30 mts. He used to get 2-3 episodes in a month. Occ non throbbing transient left temporal head ache also. 8 yrs ago he had developed left sided LNN facial palsy,treated by the Neurologist ,partially recovered. 3 yrs ago aggravation of already existing left facial weakness evaluated bythe same Neurologist.Since then he is having progressive hearing loss on the Lt ear,CT brain was done reported as normal. On exam vitals stable. BP 130/ 80 mmhg. Horizontal gaze evoked nystagmus fast component to left. 5th nerve normal .LMN partial 7th and sensoryneural deafness left side. Intact other cranial nerves.Motor system gr5/ 5 power. DTRS equal with downgoing plantars andintact sensations.Normal random walking and tandom walking showed mild unstediness. Patient is transferred to Neurosurgeon . Diagnosis and management?
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