A vestibular schwannoma is a benign brain tumor, occurring along the vestibulocochlear nerve. There are characteristic symptoms related to these tumors. The earliest symptom is often unilateral hearing loss and/or tinnitus. You may also experience vertigo and balance issues. Some patients will experience facial weakness or paralysis. A more significant symptom is hydrocephalus, which can result from cerebrospinal fluid blockage. When this occurs, patients may experience headaches, nausea, difficulty coordinating movement and difficulty focusing. Though rare, hydrocephalus can be life-threatening.
If you are experiencing the above symptoms, your doctor may suspect you have a vestibular schwannoma. Diagnosis is made using hearing and balance tests, an ear exam and diagnostic imaging.
Understanding Your Vestibular Schwannoma
The idea of a brain tumor can be scary. However, you are already taking steps in the right direction by educating yourself about vestibular schwannoma. Whether you already have a diagnosis or are still awaiting answers, developing your understanding will help you as you move forward. Becoming comfortable with medical terms and what to expect will help you in conversations with your doctor, and understanding your condition will help you feel a sense of control throughout the process. Read on to learn more about vestibular schwannoma, the characteristic symptoms and the diagnosis process.
What is Vestibular Schwannoma?
A vestibular schwannoma (also called acoustic neuroma) is a benign tumor that arises from the Schwann cells of the vestibulocochlear nerve. This is the cranial nerve responsible for hearing and balance. There is a vestibulocochlear nerve on each side of the brain, but only one is typically affected. These tumors grow very slowly, which is why symptoms don’t typically develop until later in life, commonly in patients between 30 and 60 years old.
Vestibular schwannoma is not cancer. It is benign, which means it will not spread through the body or invade nearby tissues. However, benign does not mean harmless. These tumors can grow large enough to press on nearby structures or block the flow of cerebrospinal fluid, both of which can lead to troublesome symptoms. Symptoms can also depend on the location of the tumor along the vestibulocochlear nerve. Not all patients will experience vestibular schwannoma symptoms, but many do. These symptoms are outlined for you in the section below.
Vestibular Schwannoma Symptoms
Some vestibular schwannoma symptoms are related to the effect of the tumor on the vestibulocochlear nerve. Others are related to the tumor pressing on or blocking structures due to its size. These symptoms are variable, and you may not experience them all.
Hearing Loss and/or Tinnitus
The most common early symptom of vestibular schwannoma is changes to hearing in just one ear. Patients rarely have tumors on both sides of the brain, so hearing difficulties typically only happen on one side. This can include a sense of muffled hearing and/or ringing in the ears (tinnitus). You may also experience a sense of fullness within the affected ear. Because a vestibular schwannoma grows slowly, this loss of hearing is typically gradual. However, there can be a sudden total loss of hearing, albeit less common.
Vertigo and Balance Issues
Because the vestibulocochlear nerve also transmits information about balance, you may experience vertigo and/or balance issues. These symptoms are less common than hearing loss. This is because a vestibular schwannoma grows very slowly, and the body is very good at adapting to the effects on balance as these slow changes happen. That said, some patients experience vertigo before any hearing changes.
Facial Muscle Weakness or Paralysis
If your vestibular schwannoma grows large enough, it may press on other important nerves. The facial nerve is another cranial nerve, and it is in close proximity to the vestibulocochlear nerve. If your tumor impinges upon it, you may experience weakness or even paralysis of the facial muscles on one side. This may be a subtle or dramatic effect, depending on the amount of impingement.
Sometimes a vestibular schwannoma is large enough to impinge on the brainstem, blocking the flow of CSF between the brain and spinal cord. This can lead to a condition called hydrocephalus, which means there is excess fluid causing pressure on the brain. When this occurs, patients may experience headaches, nausea, difficulty coordinating movement and difficulty focusing. Though rare, hydrocephalus can be life-threatening.
Diagnosing Vestibular Schwannoma
If you are experiencing the above symptoms, your doctor may suspect you have a vestibular schwannoma. To confirm your diagnosis, your doctor will examine your ear and test your hearing and balance. Next, you will undergo diagnostic imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT) scan to confirm the size and location of your tumor. These tests will allow your doctor to definitively diagnose your vestibular schwannoma.
Whether you know you have a vestibular schwannoma or are still awaiting a diagnosis, this is undoubtedly a difficult time for you. You’ve already made the effort to educate yourself about your condition. This is a powerful way to gain confidence during this process. As you learn your diagnosis and begin to explore treatment options in northern NJ, continue to read and speak to specialists. Your doctor will be happy to answer any questions you have, and there are resources out there to help you increase your knowledge and understanding. Continue learning as you move forward, and you will find the peace of mind it offers you to be worth the extra effort.