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Tumours of Cerebellopontine Angle

Question
17 out of 18
 

A patient is suspected to have vestibular schwannoma the investigation of choice for its diagnosis is: (LQ)



A Contrast enhanced CT scan

B Gadolinium enhanced MRI

C SPECT

D PET scan

Ans. B Gadolinium enhanced MRI scan

Investigations to be done in Case of Acoustic Neuroma

Initial step in evaluation includes an audiology testing with pure tone audiometry, speech discrimination score (S D S), acoustic reflex threshold and acoustic reflex delay. If these tests suggest a retrocochlear lesion, then imaging of the CPA is performed.

Imaging Tests in CPA tumor/Acoustic Neuroma

1. MRI - MRI with gadolinium contrast is the gold standard for the diagnosis or exclusion of vestibular Schwannoma

o It also allows for surgical planning

o MRI can detect intracanalicular tumor of even a few millimeters

2. CT scan - CT scan can diagnose CPA tumors which are larger than 1.5 cms or have atleast a 5 mm CPA components. It can miss tumors that are intracanalicular unless there is bony expansion of the internal auditory canal.

Also Know

Auditory Brainstem response I BERA:

a. In patients with vestibular Schwanoma or retrocochlear lesion - ABR is either fully or partially absent or there is a delay in the latency of wave V in the affected ear

b. CSF examination - Shows increased proteins in acoustic neuroma.

Tumours of Cerebellopontine Angle Flashcard List

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