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Cranial Nerve Lesions
A 48-year-old woman with a history of lupus with severe vision loss. Cor, coronal; Sag, sagittal.
A 55-year-old man with long-standing left-sided facial weakness. Ax, axial; CT, computed tomography.
A 56-year-old man presenting with a 10-day history of left-sided facial weakness. Ax, axial.
A 63-year-old man presenting with left-sided hearing loss. CISS, constructive interference in steady state. Ax, axial.
A 68-year-old woman presenting with right nasal ala ulceration and associated pruritus. Ax, axial; CISS, constructive interference in steady state; Cor, coronal.
DESCRIPTION OF FINDINGS
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Case A: Enhancement and diffuse T2 hyperintense signal are seen within the markedly enlarged prechiasmatic optic nerves and optic chiasm.
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Case B: A densely enhancing, T2 hyperintense lesion is seen in the left temporal bone in the expected location of the geniculate ganglion. On the serial axial CT images, correlative soft tissue density is seen along the facial nerve course (geniculate, tympanic, and mastoid segments), with widening of the bony facial nerve canal.
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Case C: Contrast enhancement is seen within the distal intracanalicular portion of the left seventh cranial nerve, with sparing of the cochlear nerve. Additional enhancement is seen in the labyrinthine and tympanic segments of the left facial nerve. The right facial nerve is normal.
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Case D: An expansile, densely enhancing mass is centered in the left CPA and internal auditory canal (IAC). Widening of the porus acusticus and IAC is observed.
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Case E: High-resolution T2 constructive interference in steady state images demonstrate marked atrophy of the right trigeminal nerve compared with the left trigeminal nerve. No abnormal enhancement is noted.
Diagnosis
Case A
Optic neuritis and chiasmitis
Case B
Left facial nerve schwannoma
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