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Medicine Miscellaneous 4adcc710

Person having cerebellar signs on the same side with hearing loss. Site of damage is

A
Left cerebellopontine angle
B
Left pons
C
Left medulla
D
Middle ear
High-Yield Explanation
(A) Left cerebellopontine angle # CEREBELLOPONTINE ANGLE TUMORS:> Tumors within the nerve canaliculi initially present with unilateral sensorineural hearing loss, unilateral tinnitus, or disequilibrium (vertigo is rare, on account of the slow growth of neuromas).> Speech discrimination out of proportion to hearing loss, difficulty talking on the telephone are frequent accompaniments.> Tumors extending into the CPA will likely present with disequilibrium or ataxia depending on the amount of extension on the brainstem.> With brainstem extension, midfacial and corneal hypesthesia, hydrocephalus, and other cranial neuropathies become more prevalent.> Cerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa, accounting for 5-10% of intracranial tumors.> Most CPA tumors are benign, with over 85% being vestibular Schwannomas (acoustic neuromas), lipomas, vascular malformations, & hemangiomas.> Most frequent non acoustic CPA tumors are meningiomas, epidermoids (primary cholesteatomas), and facial or lower cranial nerve Schwannomas.> Primary malignancies or metastatic lesions account for less than 2% of neoplasms in the CPA.> Presenting symptoms of CPA tumors (including acoustic neuromas) include the following: Hearing loss - 95% Tinnitus - 80% Vertigo/unsteadiness - 50-75% Headache - 25% Facial hypesthesia - 35-50% Diplopia-10%> Presenting symptoms can vary according to the size and location of the lesion.

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