Title
ACOUSTIC SCHWANNOMA
Modality
MRI
Part
Brain : Plain & Contrast
Technique

3 plane localizer. DWI 1000B.

Axial T2W FLAIR. Axial T2W propellar. Axial T1W, FLAIR.

T1W Sagittal. T2W coronal.

Post contrast axial, coronal & sagittal FAT SAT T1W.

Findings

Large heterogeneously enhancing extra-axial mass is seen in left cerebellopontine angle cistern causing severe compression over cerebellum, medulla, pons, midbrain and fourth ventricle.  Mild edema is seen in the left side of cerebellum.  Mass is extending into left internal acoustic meatus.  Left 7th and 8th nerve complex is not seen separately from mass.

 

Mass is iso to hypointense on T1W images and mixed intense on T2W images.  Approximate size of mass is 4.2cm (CC) x 4.7cm (AP) x 3.7cm (ML).

 

Moderate dilatation of bilateral lateral ventricles and third ventricle is seen due to compressed fourth ventricle.  CSF ooze is seen in bilateral periventricular white matter.

 

Empty sella seen with dilated subarachnoid space around bilateral optic nerves.

 

The cerebral cortex and rest of underlying white matter are unremarkable.

 

The deep nuclei are unremarkable.

 

Rest of the cerebellum and brainstem are unremarkable.

 

The intracranial ICA and vertebro-basilar arteries reveal normal flow void.

 

Diffusion imaging reveals no acute abnormality.

 

The meningeal enhancement pattern is within normal limits. 

No abnormal enhancement is seen in the sulci and CSF cisterns.

Impression

Large heterogeneously enhancing extra-axial mass in left cerebellopontine angle cistern causing severe compression over cerebellum, medulla, pons, midbrain and fourth ventricle.  Mild edema is seen in the left side of cerebellum.  Mass is extending into left internal acoustic meatus.  Left 7th and 8th nerve complex is not seen separately from mass.

 

Mass is iso to hypointense on T1W images and mixed intense on T2W images.  Approximate size of mass is 4.2cm (CC) x 4.7cm (AP) x 3.7cm (ML).

 

Moderate dilatation of bilateral lateral ventricles and third ventricle due to compressed fourth ventricle.  CSF ooze is seen in bilateral periventricular white matter.

 

Empty sella with dilated subarachnoid space around bilateral optic nerves.

 

  • Above findings are suggestive of left acoustic schwannoma causing obstructive hydrocephalus with raised intracranial tension.

 

 

 

 

Kindly correlate clinically & with other investigations (HPR).

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