前庭神经鞘瘤(VS)是由雪旺氏细胞组成的良性神经鞘瘤。这个肿瘤被包裹着,生长缓慢,起源于内耳道,延伸到小脑桥脑角(CPA)。20-44岁的个体发病率为每100,000例0.75例,双侧VS发生率为0.8/50,000例。CPA中的肿瘤是后颅窝中最常见的类型,当肿瘤扩大并压迫脑干时,会引起严重的神经系统症状或危及生命。大多数肿瘤是VS(听神经瘤),占病例的80%-90%。常见的临床症状包括听力损失,耳鸣,和眩晕.此外,这些肿瘤会压迫三叉神经和面神经。快速发展的成像技术和手术方法的进步改善了诊断和管理。一名24岁的男性在过去3年中抱怨听力受损以及头痛,头晕导致不平衡的感觉,双,和模糊的视力,以及左侧面部厚度的感觉。神经系统检查显示脑神经异常,包括双侧颅神经麻痹III,IV,VI,左颅神经V和VII,双侧颅神经VIII,右颅神经XII,和小脑异常,如意向震颤,dysmetria,气动症,宽步态,在Romberg测试中,两只眼睛睁开和闭着眼睛向右下降。患者接受了头部对比增强MRI检查,然后通过开颅手术切除右CPA肿瘤。详细了解病史,体检,和放射学被证明对建立准确的诊断和适当的管理至关重要。这被认为是必要的,以尽量减少更差的预后。
Vestibular Schwannoma (VS) is a benign nerve sheath tumors comprised of Schwann cells. This tumor is encapsulated, slow-growing, and originates from the internal auditory canal, extending into the cerebellopontine angle (CPA). The incidence in individuals aged 20-44 is 0.75 per 100,000 cases, with bilateral VS incidence of 0.8 per 50,000 cases. Tumors in CPA are the most common type in the posterior fossa and cause serious neurological symptoms or become life-threatening when tumors enlarge and compress the brainstem. The majority of tumors are VS (acoustic neuromas), accounting for 80%-90% of cases. Common clinical symptoms include hearing loss, tinnitus, and vertigo. Additionally, these tumors cause compression of the trigeminal and facial nerves. Advances in rapidly evolving imaging technology and surgical methods have improved diagnosis and management. A 24-year-old male complained of hearing impairment for the past 3 years alongside headaches, and dizziness leading to a feeling of imbalance, double, and blurry vision, as well as a sensation of facial thickness on the left side. Neurological examination showed cranial nerve abnormalities, including bilateral paresis of cranial nerves III, IV, VI, left cranial nerves V and VII, bilateral cranial nerve VIII, right cranial nerve XII, and cerebellar abnormalities such as intention tremor, dysmetria, dysdiadokokinesia, wide-based gait, and falling to the right during Romberg testing with both eyes open and closed. The patient underwent a contrast-enhanced MRI of the head, followed by a right CPA tumors excision through craniotomy. A detailed understanding of the medical history, physical examination, and radiological proved to be crucial in establishing an accurate diagnosis and appropriate management. This was considered essential to minimize a worse prognosis.