Numbness and tingling on the left side of the face. Evaluate for cranial nerve inflammation and cerebrovascular accident. Motion artifact somewhat limits evaluation. There is a large enhancing cystic mass in the left cerebellopontine angle, which extends into the internal auditory canal and has significantly increased in size compared to 12/27/2007. This lesion measures approximately 40 x 32 x 33 mm (AP x TR x CC) and exerts mass effect on the left aspect of the brainstem, especially the pons, left cerebellar hemisphere and peduncles as well as contributing to deformity of the fourth ventricle. The lateral and third ventricles are mildly prominent in size. The cisternal segment of the left trigeminal nerve is not identified due to mass effect on the left pons. There is no evidence of intracranial hemorrhage or acute infarct. The skull and extracranial soft tissues are unremarkable. There is a mucus retention cyst in the left maxillary sinus.
1. Left cerebellopontine angle cystic mass measuring up to 40 mm, markedly progressed since 12/27/2007, and most compatible with a cystic vestibular schwannoma. There is mass effect on the left aspect of the brainstem, cerebellum, peduncles with deformity of the fourth ventricle and mild prominence of the lateral and third ventricles.2. Mass effect on the cisternal segment of the left trigeminal nerve which may explain reported history of left facial sensory symptoms.