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Acoustic apoplexy: an acute complication of a common intracranial tumour

BMJ 2014; 348 doi: (Published 29 May 2014) Cite this as: BMJ 2014;348:g3268

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Re: Acoustic apoplexy: an acute complication of a common intracranial tumour

The article Acoustic Apoplexy in BMJ Minerva published 29.05.2014 highlights a potentially dangerous complication of any slow growing cerebellopontine angle tumour. However, the term 'apoplexy' might be slightly misleading. Admittedly, apoplexy is defined as a sudden haemorrhage in internal organs. The bleeding into a vestibular schwanomma affects both the acoustic as well as the vestibular part of the nerve (as in this patient with vertigo) and can be more correctly defined as a vestibulocochlear nerve apoplexy or vestibulocochlear nerve ictus.

The patient described apparently had a long standing left sided hearing loss and tinnitus. I find it curious that the tumour was not picked up before and investigated with dedicated audiometry and imaging. Early detection of vestibular schwanomma is crucial to prevent complications such as these. From the scans shown in the article, the size seems large and with increased awareness of the condition, it is seldom that we find a tumour to be this large.

Competing interests: No competing interests

31 May 2014
Soumit Dasgupta
Consultant Audiovestibular Physician/Neurotologist
Alder Hey Children's NHS Foundation Trust
Eaton Road, Liverpool L12 2AP