40-year old gentleman presented with left-sided hearing loss, which slowly deteriorated over time. At the time of presentation, he was completely deaf. Other symptoms included mild dizziness and imbalance. On examination, he had left-sided sensori-neural hearing loss. Tandem gait was impaired.
He had consulted several ENT doctors over the past 4 years, and he was symptomatically treated. He was referred to me for neurological assessment.
In view of deafness and mild cerebellar ataxia, I ordered for an MRI scan of brain. MRI showed a large cerebello-pontine (CP) angle mass lesion, which was iso- to hypointense on T1W images, hyperintense on FLAIR and T2W images, and enhanced with contrast. These features were consistent with a diagnosis of left vestibular schwannoma. He was referred to Neurosurgery department for surgical excision of tumor.
Conclusion: It is always advisable to get an MRI done in a patient with unexplained hearing loss, especially, if the hearing loss is unilateral.