Pediatric Acoustic Neuroma

  • Etiology: Arise from vestibulocochlear nerve (cranial nerve VIII)
  • Imaging:
    — Solid nodular mass with intracanalicular component that results in widening of porus acusticus
    — Intense contrast enhancement
    — Cystic degeneration can be present when tumor is large
    — May have hemorrhage
    — Do not have calcification
  • DDX: Cerebellopontine angle masses
  • Complications:
  • Treatment: Stereotactic radiosurgery or microsurgey
  • Clinical:
    — 80% of cerebellopontine angle masses
    — If present bilateral is strongly suggestive of neurofibromatosis Type 2
    — Present with sensorineural hearing loss or non-pulsatile tinnitus

Radiology Cases of Acoustic Neuroma

Radiology Cases of Bilateral Acoustic Neuromas in Neurofibromatosis Type 2

MRI of acoustic schwannomas in a patient with neurofibromatosis Type 2
Axial T1 MRI with contrast of the brain shows bilateral homogeneously enhancing masses in the cebrebellopontine angles. The patient also had an intracranial meningioma.
CT of acoustic neuroma
Axial CT without contrast of the temporal bones shows the left internal auditory canal (right) is smoothly expanded and much larger than the right internal auditory canal (left). This enlargement of the left internal auditory canal corresponded to the location of an enhancing mass within it on an MRI of the brain performed with contrast from an outside institution.