Acoustic neuroma also known as a vestibular schwannoma or acoustic neurilemmoma is a slow-growing tumor. It arises from the myelin sheath of the nerve formed of Schwann cells. It is commonly seen from the vestibular part of VIII cranial nerve. It is present in internal acoustic meatus or cerebellopontine angle located at a petrous part of the temporal bone in the posterior cranial fossa. The causes of this tumor include radiation exposure, neurofibromatosis type 2, etc.
Acoustic neuromas are classified on the basis of size. Small tumors are being less than 1.5 cm, medium tumors are between 1.5 to 2.5 cm and large acoustic neuroma being greater than 2.5 cm in size.
The presentation of acoustic neuroma is very characteristic. Most number of cases present with unilateral hearing loss. The hearing loss usually gets detected when it becomes moderate to severe. Tinnitus is another major symptom associated with it. Various other symptoms are also associated depending upon the size tumor. Vertigo, dizziness, nausea, loss of balance, vomiting, headache are common features. Hypertension, hydrocephalus, neurological deficits, paresthesias, abnormal sensations, coma can also occur in later stages.(1)
Do Acoustic Neuromas Make You Tired?
Acoustic neuroma itself does not cause tiredness or other personality changes but the symptoms associated with it can be the reason for personality changes and laziness. Headache, nausea is the ones that can make a person look tired and lazy. When a person is having a headache continuously for a long period of time, it eventually becomes evident on the face and personality of the person. The patient cannot concentrate on the work and always looking for rest and medications. Sleep also gets affected by the symptoms which in turn increase the daytime sleepiness and laziness.
Persistent vomiting can lead to features of dehydration. The look on the face becomes drowsy, the eyes become sunken, the mucous membranes become pale and dry and the skin turgor becomes loose. When acoustic neuroma becomes so large that it compresses 9th 10th and 11th cranial nerves, then the symptoms of palpitations and tachycardia begins to appear because of inhibition of vagus effect on the heart.
Can Acoustic Neuromas Cause Personality Changes?
Personality changes can be seen in acoustic neuroma because of the symptoms as well as pressure effects exerted by the tumor. Tinnitus is a very irritating feature of acoustic neuroma. It usually occurs as a persistent symptom and can make a person add irritability in its personality. Hearing loss can make look like the patient less understandable which could be very disappointing to the patient. Story making of the skipped parts of an incomplete listening tall due to hearing loss could be seen in such patients who are termed as confabulation.
Headache, nausea are also other features which can make a person look restless and agitated. The persistent symptoms make it improbable for the patient to concentrate on anything and irritability increases. Hypertensive changes occurring due to increased intracranial tension in the large space-occupying lesion can make the person angry and impulsive all the time. Abnormal bodily sensations can make the patient fearful. The patient can go into a coma in later stages. Hearing aids are needed if the tumor becomes symptomatic which is sometimes cosmetically distressing to many patients.(1)
Even without being a malignant tumor, an acoustic neuroma can significantly affect the quality of life. The symptoms presented in this tumor are responsible for personality changes in the patients. Sad and tired-looking face with increased daytime sleepiness can be the only presenting features of the tumor but thorough history taking reveals other significant symptoms which are usually ignored by the patients. Rage and impulsive behavior occur in the last stages when the tumor is big enough to compress other vital structures and also the pain becomes unbearable for the patient. Strong analgesia would be required in such cases to relieve the pain. Early diagnosis and adequate treatment can save the patient from all these problems.
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