Acoustic neuroma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Acoustic schwannomas, also known as vestibular schwannomas, are relatively common tumours that arise from the vestibulocochlear nerve (CN VIII) and represent ~80% of cerebellopontine angle masses. It is a benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear nerve (8th cranial nerve). A type of schwannoma, this tumor arises from the Schwann cells responsible for the myelin sheath that helps keep peripheral nerves insulated Bilateral acoustic schwannomas are strongly suggestive of neurofibromatosis type 2 (NF2).These tumours classically present on imaging as a solid nodular mass with an intracanalicular component which often result in widening of the porus acusticus. They usually have vivid contrast enhancement and, when larger, cystic degeneration can be present. Haemorrhagic areas may also be seen, but calcification is typically not present. The tumour is also sometimes called an acoustic neuroma, but the term "acoustic" is a misnomer, as the tumor rarely arises from the acoustic division of the vestibulocochlear nerve. The term "neuroma" is also a misnomer, since it means "nerve tumor" but an acoustic neuroma is a Schwannoma. Acoustic neuroma may be classified into three subtypes based MRI, and into four subtypes based on microscopic histopathology. On microscopic histopathological analysis, acoustic neuroma is characterized into two types, Antoni A and Antoni B, based on growth patterns.