A 68-year-old man has many months history of progressive hearing loss, unsteady gait, tinnitus, and facial pain. An MRI scan reveals a tumor at the cerebellopontine angle. Which of the following cranial nerves is this tumor most likely to affect?
An acoustic neuroma is most likely to lead to a palsy of the eighth cranial nerve. Deafness, headache, ataxia, tinnitus, and diplopia are seen, as well as facial paresthesia. Acoustic neuromas represent 5-10% of all intracranial tumors. They develop from Schwann cells and generally grow very slowly. They may be very large before symptoms develop.