# Unmasking vestibular schwannoma: A series of unusual cases

## TL;DR

This paper presents four unusual cases of vestibular schwannoma to highlight the importance of recognizing atypical symptoms for timely diagnosis.

## Contribution

The study contributes by showcasing rare clinical presentations of vestibular schwannoma that may lead to diagnostic delays.

## Key findings

- Atypical audiological findings can delay the diagnosis of vestibular schwannoma.
- Prompt MRI diagnosis is essential for optimal management and prognosis.
- Misdiagnosis of auditory neuropathy may occur due to absent ABR with preserved CM.

## Abstract

Vestibular schwannoma (VS) is a benign, slow-growing tumor that accounts for 80–90 % of cerebellopontine angle (CPA) tumors. While classic symptoms like hearing loss, tinnitus, and vertigo are well-recognized, atypical presentations can delay diagnosis.

We present four unusual cases of VS. The first patient, a 33-year-old woman, initially presented with transient tinnitus and later developed peripheral vertigo. The second case involved a 52-year-old man with sudden hearing loss, vertigo, and aural fullness. The third case was a 17-year-old female with unilateral auditory neuropathy. The fourth patient, a 39-year-old woman, presented with intermittent tinnitus, balance disturbances, and facial stiffness.

Detailed history, physical examination, and audiological evaluation are crucial for identifying patients at risk for vestibular schwannoma, especially with atypical audiological findings, to avoid misdiagnosis.

This case series emphasizes the significance of considering VS as a differential diagnosis for atypical symptoms. Early recognition and proper practice can lead to optimal outcomes for patients and contribute valuable insights to the scientific field by broadening the understanding of the diverse spectrum of VS symptoms.

•Unusual audiological profiles stress the need for vigilance to avoid delays in diagnosis and treatment.•Small or atypically located tumors can hinder early detection, complicating diagnosis and management.•Prompt diagnosis using MRI is essential for the best possible management and prognosis.•An absent ABR with a preserved CM could result in the misdiagnosis of auditory neuropathy.

Unusual audiological profiles stress the need for vigilance to avoid delays in diagnosis and treatment.

Small or atypically located tumors can hinder early detection, complicating diagnosis and management.

Prompt diagnosis using MRI is essential for the best possible management and prognosis.

An absent ABR with a preserved CM could result in the misdiagnosis of auditory neuropathy.