Magnetic resonance imaging: is a single scan ever enough for the diagnosis of acoustic neuroma?
A patient presented with unilateral, right-sided hearing loss and tinnitus and underwent gadolinium-enhanced magnetic resonance imaging (MRI). A pure tone audiogram showed a right-sided sensorineural hearing loss. The MRI scan was initially negative but when repeated seven years later, following a further deterioration of symptoms, it showed a 2 mm, right-sided acoustic neuroma. This case has great potential significance for the diagnosis of acoustic neuroma, and it may raise medico-legal issues regarding the exclusion of this diagnosis. The case illustrates that a single negative scan may not be adequate if pure tone audiograms show deterioration in hearing loss.
Kernohan
M D
MD
Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK. mdkernohan@ukgateway.net
Blackmore
K J
KJ
Johnson
I J M
IJ
Zammit-Maempel
I
I
D000328:Adult; D001301:Audiometry, Pure-Tone / Q000592:standards; D003657:Decision Making; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D009464:Neuroma, Acoustic / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome