If you have acoustic neuroma, you may not notice it for the first few years because the tumor grows very slowly.
It is not the tumour but the environment that causes symptoms
It is not the tumour itself that is important for symptoms, but the environment surrounding the tumour. Symptoms only arise when the tumour displaces other structures, preventing them from functioning properly. Despite this dependence on the location of the tumour, some typical symptoms can be described which occur in a large proportion of patients.
Reduction of hearing
The tumor develops as described from Schwann's cells located around the vestibulocochlear nerve. When this irritates or depresses the nerve, it leads to increasing hearing loss on the affected side. Usually the first thing noticed is a hearing loss at high frequencies (e.g. birds chirping). Often, the affected person only notices such a hearing loss by chance - e.g. during a telephone conversation. This then becomes more and more pronounced as the tumour grows and can affect not only the organ of hearing but also the organ of balance.
What is most significant is that in most cases the damage is unilateral. It is very unlikely that two acoustic neuromas will form and grow at the same time in the same place, and this is only common in certain hereditary diseases.
In addition to a reduction in hearing ability, tinnitus can also occur. This is an annoying and unpleasant sound that is constantly heard even though it is not actually there. For most patients, tinnitus is far more disturbing and noticeable than the faint hearing loss that initially occurs. Nevertheless, hearing loss is the most commonly described initial symptom of acoustic neuroma.
Restriction of the organ of balance
As the tumor grows, the limitations become more severe. Dizziness and balance disorders often occur. Both spinning and swaying vertigo can occur, which are very discrete at first, but then increase significantly and thus also greatly affect everyday life.
In addition to the dizziness symptoms, a so-called nystagmus can also occur. This means that one eye starts to tremble again and again when trying to track an object.
Pain and loss of sense of touch in the face
As mentioned earlier, a lot of cranial nerves are located in the area of the cerebellopontine angle. So are the nerves that supply the face. This can result in severe facial pain, movement disorders or even loss of sensation. However, these symptoms are very rarely observed today, since the tumor would have to be relatively large in order to damage the corresponding nerves. Thanks to new examination methods, however, acoustic neuroma is diagnosed and treated much earlier today.
Other neighbourhood symptoms
There can be a whole range of other so-called neighbourhood symptoms. One of the more common symptoms is seeing double images.
In the late stage of the tumour, the cerebellum can also be affected. This leads to gait disorders, as the cerebellum is mainly responsible for the coordination of movement.
Brain pressure in large tumours
If the tumour remains undetected for a long time, so-called intracranial pressure symptoms occur. These occur when the entire brain is under pressure due to the growth of the tumour, as the skull cannot expand. This can be the case even if the tumour is only a few centimetres in diameter.
The symptoms include headaches, which are mainly heard in the area of the back of the head, visual disturbances up to the loss of vision, vomiting and increasing personality changes.
In the majority of cases, the symptoms initially go unnoticed or are only very discreetly noticeable. This is due to the slow growth rate. This is because the brain is very adaptable and tries to compensate for the symptoms by increasing constriction over a long period of time.
Only when the displacement by the tumour is so great that nerve tracts are affected and nerve cells damaged, do the symptoms slowly set in. In many cases, this takes the tumor several years, if not decades.
Rapid symptoms due to haemorrhages
Nevertheless, one should never assume that it cannot be a tumor if symptoms appear suddenly and unexpectedly or worsen drastically. For example, acute bleeding into the tumor can cause massive symptoms within seconds or minutes. These may be accompanied by hearing loss, tinnitus, dizziness and gait disturbances. Sometimes the symptoms are confused with those of a hearing loss, as they are very similar. In a hearing loss, a sudden and almost complete hearing loss forms in the ear affected by the tumor.