Central vestibulocochlear pathology: role of MRI and CT

Hearing loss, tinnitus, dizziness and disequilibrium are frequent complaints of patients with labyrinthine and retrolabyrinthine lesions. The objective of a neurotological examination is to establish the presence and location of a lesion, whether it is labyrinthine (cochlear or vestibular) or intracranial. On the basis of neurotological and vestibular results, provided by neurotologist or otolaryngologist, if a retrocochlear or retrovestibular lesion is suspected, a magnetic resonance imaging (MRI) or computed tomography (CT) study of the head is obtained with particular attention to the acoustic nerve and posterior fossa. MR and CT are exceedingly helpful to identify the extraaxial and intra-axial lesions involving the vestibulocochlear nerves and their central pathways. The appearances on MR and CT scans of varied pathological entities involving the central vestibulocochlear pathways are reviewed and illustrated.