Presentation
Vertigo and left facial paralysis
Patient Data
There is an extra-axial expansive mass in the left cerebelopontine angle, with oval shape, well-defined, heterogeneous, hypointense in T1, hyperintense in T2 and FLAIR, foci of hemosiderine are well noted with great enhancement in contrast phase. It exerts mass effect displacing bulb, midbrain and left cerebellar lobe to the right side, spreading through the ipsilateral pontocerebellar cistern and the internal acoustic meatus with involvement of the VII cranial nerve.
Case Discussion
This case shows the appearance of a great expansive vestibulocochlear schwannoma, the behavior in the different sequences with the intense heterogeneous enhancement post-contrast, very common in large tumors, the mass effect displacing the adjacent structures, and invasion of the internal acoustic meatus affecting the facial nerve. This explains facial nerve paralysis in this patient.
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