Acoustic neuroma

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Central nervous system

Acoustic neuroma

Alternative Names:

Vestibular schwannoma; Tumor - acoustic; Cerebellopontine angle tumor; Angle tumor
Symptoms:

The symptoms vary with the size and location of the tumor. Because the tumors grow so slowly, symptoms usually arise after the age of 30.

Common symptoms include:

tinnitus (ringing) in the affected ear
hearing loss in the affected ear
vertigo (an abnormal sensation of movement)

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Less common symptoms include:

headache
- upon awakening in the morning
- which awakens patient from sleep
- aggravated by lying down, reclining position
- aggravated by standing up
- aggravated by coughing, sneezing, straining, lifting (Valsalva maneuver)
- with nausea or vomiting
difficulty understanding speech (out of proportion to total hearing loss)
dizziness
loss of balance
numbness in the face or one ear
pain in the face or one ear
transient vision abnormalities

Signs and tests:

The health care provider may diagnose an acoustic neuroma based on the history, neurological examination or testing of the patient. The results of a physical examination are often unremarkable, except for the following signs:

If the tumor is large, there may additionally be signs of increased pressure on the brain (increased intracranial pressure), including the following:

nausea and vomiting
unilateral (one side only) dilated pupil -- see eyes, pupils different size
lethargy (sleepiness)

The most useful (i.e., sensitive and specific) test to identify acoustic neuromas is an MRI of the head. Other useful tests used to diagnose acoustic neuroma and to differentiate it from other causes of dizziness or vertigo include:

head CT
audiology (a test for hearing)
caloric stimulation (a test for vertigo)
electronystagmography (a test of equilibrium and balance)
brainstem auditory evoked response (BAER, a test of hearing and brainstem function)