[Ocular tilt reaction. A rare complication after acoustic neuroma surgery]

Visual disturbances after acoustic neuroma surgery are very rare complications. We present a patient with diplopia after a middle fossa approach for resection of an acoustic neuroma. The patient presented ocular torsion and tilts of subjective visual vertical which is typical for the ocular tilt reaction. It is generally agreed that this reaction is secondary to a dysfunction of the tonic bilateral vestibular inputs that stabilize the eyes and head in a normal upright position in the roll plane. It has also been described after denervation of the utricle and injury of the brain stem.