Presentation
Left-sided hearing loss.
Patient Data
Left cerebellopontine solid mass lesion, with homogeneous texture, smooth regular surface, globular in shape and epicentered on internal auditory meatus. It shows homogeneous low signal on T1 and high signal on T2 and FLAIR. Homogeneous post-contrast enhancement is noted. Foci of blooming artifact on SWI are noted reflecting intratumoral microhemorrhages.
It shows widening of left internal auditory canal with intracanalicular component. No cystic changes. No associated hyperostosis or thickened/enhanced dural tail.
It exerts mass effect in the form of compression of left side of brain stem and left cerebellar hemisphere.
Case Discussion
The study shows typical MRI features of a vestibular schwannoma. The presence of intratumoral microhemorrhages on SWI imaging can help differentiate vestibular schwannomas from CPA meningiomas as the presence of microhemorrhages in the lesion is a well-known pathologic feature of vestibular schwannomas 1-3.
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