Large CP Angle tumor Presenting with Long-standing Deafness

T1W MRI images (Axial)
T2W MRI images
Post contrast T1W Axial image
Post contrast T1W coronal MRI image

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.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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