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Acousticneuroma聽神經(jīng)瘤IntroductionAcousticneuromaoriginatefromvestibularbranchofaucousticnerveHistologicfeature:schwanoma,neuroma,Predilection:30-50yUnilateral:majorityBilateral:TypeIIacousticneuromaVestibular-前庭PathologyPredominate:internalauditorycanalExtensiontoCPACompressiononbrainstemandbrainhydropsAnterior:trigeminalnerve,Medial:abducentnerveInferior:IX,X,XI,XIICPA-小腦橋腦角ClinicalpresentationsHearinglossandtinnitusProgressiveHL90%10%ofpatientscomplainofsuddenHL.UnbalanceOtalgiaandcompressionduetodepressionofsensorfiberoffacialnerveInvolvementoftrigeminalnerveCompressionofcerebellumandbrainstem:ataxia,nystagmusandintracranialhypo-pressureOtalgia-耳痛，ataxia-共濟(jì)失調(diào)，nystagmus-眼球震顫CTscantumorinCPA,densityisvariformenlargementofinternalauditorycanalEnhancedCTscan,theyaremarkedlyenhanced.MRscan（2）Thetumorswereofhypooriso-hypointensityonT1weightedimagesandhyperoriso-hyperintensityonT2weightedimages.（3）AfterenhancedthetumorswerehomogeneouslyorinhomogeneouslyorcircularlyenhancedMRscan(4）Themarginsofthetumorsweresmoothandwelldelineated.（5）Theaffectedinternalauditorycanalusuallybecameshorterindepthandlargerinposterioranteriordiameter.（6）MRIappearancesofmicroacousticneuromaswerethattheaffectedⅦ,ⅧnerveswerenormalinsizeandthetumorrevealednodularorpointenhancementatcontrastenhancedSamecaseT2WIDifferentialDiagnosesepidermoidcyst1、Thetumorsweredifferentinsizeandhadirregularshapes,thecontourswerelobulatedorsmoot2、OnCT,mostcasesarehomogeneoushypo

density,andonMRI,mostcasearehomogeneous

hypointenseimagingonT1WI,andhomogenoushyperintenseonT2WI.PartialcasesareinhomogenoushyperintensityonFLAIR3、mostcasesarenotenhancedDifferentialDiagnoses

trigeminalneuroma1、locatedinmiddlecranialfossorposteriorcranialfoss;samecaseswithtypicaldumb-belllikeinshapegrewacrossmiddleandposteriorcranialfoss2、thelesionsshowedsmallinsizeandnocapsula,butthatlargeinsizecanhascapsularornecrosis,3、Thetumorswereofslightlyhypooriso-hyposignalintensityonT1WIandhyperorisohypersignalintensityonT2WI.ThehypoormixeddensitywereshowedbyCT.trigeminalneuroma4、Oncontrastscan，thetumorswereenhancedhomogeneously,inhomogeneously,circularlyornodularly.Hypervascularanddot-stainedtumorswerefoundonDSA5、TherootsoftrigeminalnervesthickeningwithdysfunctionanderosionofpetrousbonewerefoundinmostcaseManagementsSurgeryMiddlecranionectomy:usefulhearingTranslab

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