Vestibular Schwannoma in an Elderly Patient Presenting With Tinnitus and Vertigo

The vestibular schwannoma (VS), previously known as acoustic neuroma, is a benign tumor that originated from the edge of the Schwann's sheath of the eighth cranial nerve. It is considered the most frequently diagnosed intracranial benign tumor, of low lethality rate, and unknown etiology. Because of improvement of diagnostic tests and widespread use of magnetic resonance imaging (MRI) and computed tomography (CT) scan, the prevalence of diagnosed acoustic neuroma has increased. Current studies suggest rate may be higher considering undiagnosed asymptomatic patients and incidental findings on radiological examinations in older adults. The etiology of VS is still unclear, and investigations for risk factors are limited. Symptoms at presentation can vary from asymptomatic to complete hearing loss. Medical management can include a “wait and watch” approach, surgical resection, or radiation therapy. The decision depends on the patient's age at identification, tumor size, severity of symptoms, patient's preference, and other medical conditions.