Case 20 CPA schwannoma

Figure 20: sagittal and coronal with contrast.

• Q1: D.D. of CPA lesions?
• Vestibular schwannoma is the most common followed by meningioma, Epidermoid.

• Q2: Which of the following is the most common tumor of the cerebellopontine angle?
  1. Arachnoid cyst.
  2. Epidermoid cyst.
  3. Facial nerve schwannoma.
  4. Meningioma.
  5. Trigeminal schwannoma.
  6. Vestibular schwannoma.
• Vestibular schwannoma.

• Q3: All the following features are those of vestibular schwannoma EXCEPT: –

1. Extension to the Meckel cave.
2. “Ice cream cone” appearance.
3. Intracanalicular component.
4. May have cystic components.
5. Widening the porus acusticus.

• Extension to the Meckel cave.

• Q4: Which of these is NOT a recognized cause of pulsatile tinnitus?
  1. Aberrant internal carotid artery.
  2. Idiopathic intracranial hypertension.
  3. Jugular bulb dehiscence.
  4. Sigmoid plate diverticulum.
  5. Vestibular schwannoma.
• Vestibular schwannoma.

• Q4: Is facial nerve palsy common in CPA acoustic schwannomas, and what is the cause?
• Facial nerve palsy is uncommon in cases of CPA acoustic schwannomas due to the resilience of motor nerves like the facial nerve, which can accommodate compression and stretching. In contrast, the cochlear nerve, which mediates hearing, is usually affected early due to the sensitive nature of sensory nerves.