cranial nerve lesion acoustic neuroma
DESCRIPTION
Cranial Nerve Lesion Acoustic Neuroma. Presented By: Emma Morales Gigi Sanchez Christine Achenbach Josefina Delgado. Introduction of Cranial Nerve Eight: Vestibulocochlear Nerve. Arises in the inner ear and goes to the pons Two anatomically and functional parts: Cochlear Nerve - PowerPoint PPT PresentationTRANSCRIPT
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Cranial Nerve LesionCranial Nerve Lesion Acoustic Neuroma Acoustic Neuroma
Presented By:Emma MoralesGigi Sanchez
Christine AchenbachJosefina Delgado
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Introduction of Cranial Introduction of Cranial Nerve Eight: Nerve Eight: Vestibulocochlear NerveVestibulocochlear Nerve Arises in the inner ear and goes to the Arises in the inner ear and goes to the
ponspons Two anatomically and functional parts:Two anatomically and functional parts:
Cochlear NerveCochlear Nerve Vestibular NerveVestibular Nerve
Cranial Nerve XIII functions in hearing Cranial Nerve XIII functions in hearing and balanceand balance
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Vestibulocochlear Nerve Vestibulocochlear Nerve VIIIVIII
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Clinical Case of Acoustic Clinical Case of Acoustic Neuroma Neuroma (Vestibular (Vestibular Shwannoma)Shwannoma)RobinRobin
•European-American womanEuropean-American woman•51 years old51 years old•Professional ExecutiveProfessional Executive•Maintained reasonable dietMaintained reasonable diet•Overall in perfectly good Overall in perfectly good
healthhealth
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Robin’s SymptomsRobin’s Symptoms•Symptoms started 2 years agoSymptoms started 2 years ago
–telephone communication telephone communication distorted -right eardistorted -right ear
–tinnitus-right eartinnitus-right ear–dizzy spells at workdizzy spells at work–bumping into things bumping into things everywhereeverywhere
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Robin’s visit to General Robin’s visit to General PhysicianPhysician
•First General PhysicianFirst General Physician•diagnosed her with inner ear diagnosed her with inner ear imbalance from her last plane trip imbalance from her last plane trip
• Antivert medication was prescribedAntivert medication was prescribed•no change in symptomsno change in symptoms
•Second Physician Second Physician •MRI scanMRI scan•found small 0.9cm Acoustic found small 0.9cm Acoustic NeuromaNeuroma
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Background: Background: What is Acoustic What is Acoustic Neuroma?Neuroma? Non-cancerous tumor of the eighth Non-cancerous tumor of the eighth
cranial Nerve leading from brain to cranial Nerve leading from brain to inner earinner ear
Usually grow slowly over a period of Usually grow slowly over a period of yearsyears
Not Hereditary: Occur Not Hereditary: Occur spontaneously without any spontaneously without any evidence of inheritable patternsevidence of inheritable patterns
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Common SymptomsCommon Symptoms Major symptom: Hearing Loss 95% Major symptom: Hearing Loss 95%
of those with tumorof those with tumor TinnitusTinnitus VertigoVertigo HeadachesHeadaches Unsteadiness-poor coordinationUnsteadiness-poor coordination Facial numbness, tingling, Facial numbness, tingling,
twitchingtwitching
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Signs of Acoustic Signs of Acoustic NeuromaNeuromaDecreased speech Decreased speech
discrimination discrimination NystagmusNystagmusAbnormal facial Abnormal facial
electromyogramelectromyogram
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Statistical InformationStatistical Information Found in autopsy in less than one Found in autopsy in less than one
in one-hundred of the general in one-hundred of the general populationpopulation
Hearing loss and symptoms occur Hearing loss and symptoms occur in about one person in 100, 000in about one person in 100, 000
Diagnosed in patients between Diagnosed in patients between the ages of 30-60 the ages of 30-60
Cause unknownCause unknown
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Clinical Findings: TestClinical Findings: TestENGENG(Electronystagmogr(Electronystagmogr
aphy test)aphy test)Caloric TestCaloric Test
MRI scanMRI scan
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MRI Classification for ANMRI Classification for AN Entirely IntracanicularEntirely Intracanicular Intercranial extension without Intercranial extension without
brainstem distortionbrainstem distortion Intracranial extension with Intracranial extension with
brainstem distortionbrainstem distortion
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Diagnosis: Findings on Diagnosis: Findings on Clinical CaseClinical Case
Detected small .9cm Acoustic Neuromaaffected hearing loss and balance
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Treatment OptionsTreatment Options ObservationObservation Surgery- Microsurgical tumor Surgery- Microsurgical tumor
removalremoval• Partial tumor removalPartial tumor removal• Total tumor removalTotal tumor removal
RadiationRadiation• Gamma KnifeGamma Knife• FSRFSR
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Clinical Case PlanClinical Case Plan Patient Robin decided on RADIATIONPatient Robin decided on RADIATION FSR treatment FSR treatment
• 5 treatments a week5 treatments a week• for 5 weeksfor 5 weeks
Robin’s Follow-upRobin’s Follow-up• 1 year - improved hearing1 year - improved hearing• 2 years – tumor reduced and 92% 2 years – tumor reduced and 92%
hearing backhearing back• no significant side effectsno significant side effects
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Neurobiology of Acoustic Neurobiology of Acoustic Neuroma: Structures Neuroma: Structures InvolvedInvolved Eighth Cranial nerve Eighth Cranial nerve
• Vestibular & Cochlear DivisionsVestibular & Cochlear Divisions
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Auditory Canal Auditory Canal
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Internal Auditory Canal Internal Auditory Canal
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Growth patternsGrowth patterns Stage 1Stage 1
Stage 2Stage 2
Stage 3Stage 3