Acoustic neuroma Flashcards
Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve), arising from the Schwann cells of the nerve sheath. Are these tumours benign or malignant?
- typically benign
BUT 5-10% can develop into neoplasms, increasing risk of malignancy
Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve). Does this affect central or peripheral nerves?
Peripheral
- Schwann cells = peripheral myelination
- Oligodendrocytes = central myelination
Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve). What is the incidence of these?
1 - 10,000 cases per 100,000
2 - 1000 cases per 100,000
3 - 100 cases per 100,000
4 - 1 cases per 100,000
4 - 1 cases per 100,000
Affect men and women equally
Acoustic neuromas, also called vestibular schwannomas are tumours of the vestibulocochlear nerve (eighth cranial nerve) can affect any age, but are they more common in young or older adults?
- older adults
Typically 50-60 year olds
Which part of the brain do acoustic neuromas typically occur in?
1 - brainstem
2 - pons
3 - midbrain
4 - cerebellopontine angle
4 - cerebellopontine angle
Are acoustic neuromas typically unilateral or bilateral?
- unilateral
Acoustic neuromas are typically unilateral, but can be bilateral in what condition?
1 - neurofibromatosis type 2
2 - polycystic kidney disease (PKD)
3 - jacobsen syndrome
4 - down syndrome
1 - neurofibromatosis type 2
Remember 2 neuromas and its in type 2
Acoustic neuromas can affect all of the following cranial nerves, EXCEPT which one?
1 - CN VIII (8)
2 - CN X (10)
3 - CN VII (7)
4 - CN V (5)
5 - cerebellum
2 - CN X (10)
Acoustic neuromas typically cause unilateral hearing loss. Is this conductive or sensorineural?
- sensorineural
Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which 2 of the following are effects of acoustic neuromas on CN 8?
1 - conductive hearing loss
2 - shuffling gait
3 - vertigo and balance issues
4 - sensorineural hearing loss and tinnitus
3 - vertigo and balance issues
- vestibular
4 - sensorineural hearing loss and tinnitus (unilateral)
- cochlear
CN 8 = vestibulocochlear nerve
Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which of the following are effects of acoustic neuromas on CN 5?
1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - dilated pupil
4 - pain in the face
4 - pain in the face
CN 5 = trigeminal nerve
Acoustic neuromas can affect all of the following cranial nerves, 5, 7 and 8. Which of the following are effects of acoustic neuromas on CN 7?
1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - dilated pupil
4 - pain in the face
1 - numbness and facial muscle weakness
CN 7 = facial nerve
Acoustic neuromas can affect all of the following cranial nerves, 5, 7, 8 and the cerebellum. Which of the following are effects of acoustic neuromas on the cerebellum?
1 - numbness and facial muscle weakness
2 - change in taste on posterior 1/3 of tongue
3 - ataxia
4 - pain in the face
3 - ataxia
Typically patients have a wide based gait
If a patient presents and you suspect an acoustic neuroma, which of the following should you do?
1 - wait and see as they are benign
2 - refer urgently to ENT
3 - standard referral to ENT
4 - prescribe physio and NSAIDs
2 - refer urgently to ENT
Patients are typically monitored initially
Sensorineural hearing loss is a characteristic of acoustic neuromas. Which test is most accurate at diagnosing a sensorineural hearing loss?
1 - Rinnies test
2 - Webers test
3 - Audiometry
4 - Whispering in the patients ear
3 - Audiometry
What is the gold standard imaging used to diagnose a patient with suspected acoustic neuroma?
1 - head X-ray
2 - head CT
3 - head MRI
4 - heat PET
3 - head MRI
Gadolinium contrast is used to enhance the image
CT may be performed as well
