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| T1 pre-gad | T1 post-gad | T1 post-gad |
Diagnosis: Acoustic schwannoma
Acoustic schwannomas typically present in adults with high frequency hearing loss and tinnitus. Vestibular symptoms are a late manifestation. They enhance strongly and have an ice cream cone appearance due to the combination of intracanalicular and cisternal components. Larger schwannomas may undergo cystic change as in this case. Hemorrhage and calcification are uncommon. Arachnoid cysts are associated in 7% of acoustic schwannomas. Bilateral acoustics are seen in neurofibromatosis II. The intracanalicular extension and lack of a dural tail strongly favor schwannoma. A meningioma would be more broad based without the prominent intracanalicular extension or necrosis. Other CP angle masses include ependymoma, dermoid, metastases and aneurysms of the anterior inferior cerebellar artery. Related Cases
