Vestibular schwannoma commonly presents with which symptom?

• A. Vision changes
• B. Hearing loss
• C. Seizures
• D. Weakness

Answer: (B)

Vestibular schwannoma arises from the Schwann cells of the vestibular branch of the eighth cranial nerve at the cerebellopontine angle. The most common presenting feature is unilateral sensorineural hearing loss on the affected side, because the tumor irritates and compresses the cochlear component of the same nerve as it grows. Tinnitus and imbalance often accompany the hearing loss, but the hallmark early symptom is the progressive unilateral hearing loss. Vision changes would point to involvement of optic pathways, seizures are not typical for a tumor in this location, and weakness isn’t usually an early sign since motor pathways are spared. So, hearing loss best fits the typical presentation.