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Clinical Problem Solving: Radiology
February 2004

Radiology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2004;130(2):243. doi:10.1001/archotol.130.2.243

A 64-year-old man presented with a 3-year history of progressive deafness and tinnitus of the left ear. He had no vertigo or imbalance. The findings of his physical examination, including otoscopy and otomicroscopy, were normal. One year earlier, a computed tomographic scan of his brain (Figure 1) had shown a lesion in the cerebellopontine angle (CPA) that was interpreted as an acoustic neuroma. Audiometry, which was performed during his first visit (Figure 2), showed a dead ear on the left and a downward-sloping sensorineural hearing loss in the right ear, compatible with presbycusis. Magnetic resonance imaging (MRI) was then performed. Figure 3 shows the CPA lesion before contrast injection, and Figure 4 shows a contrast-enhanced MRI scan.

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