CASE HISTORY / CLINIC:
55-year-old patient with recurring acute hearing loss on the left, the last episodes of which occured last year and 8 weeks ago. A steep drop of the upper tones on the left of the audiogramm
Normal fingings of ear microscopy. Failure of the equilibrium organ in the equilibrium test.

FINDINGS:
The CISS-Sequence (top left) demonstrates a displacement of the cerebrospinal fluid around the left cerebellopontine angle and the left internal auditory meatus depicting a hypodense mass lesion. The mass lesion in the cerebellopontine angle and internal auditory meatus shows a significant signal enhancement in the post-contrast T1-weighted axial image (top right). This hyperdense mass lesion in the left cerebellopontine angle and internal auditory meatus is also visualized in the post contrast T1-weighted coronary image (below left).
Excellent demonstration of the endolymph-filled semicircular canals and the cochlea with it's basal helices in the 3-D image (below right). No visualization of loss in signal intensity in the fluid-filled cerebellopontine angle and internal auditory meatus.


DIAGNOSIS:
Left-sided acoustic neurinoma

DIFFERENTIAL DIAGNOSIS:
Meningeoma



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