Acoustic Apoplexy: A Rare Complication of Vestibular Schwannoma

Vestibular schwannoma is the most common tumor encountered in the internal auditory canal and cerebellopontine angle. Clinically significant intratumoral hemorrhage is a rare complication of vestibular schwannoma that results in a clinical syndrome of acute neurologic decline, termed acoustic apoplexy. This syndrome causes sudden hearing loss and possible vertigo, headache, additional cranial nerve deficits, and even death. The neuroradiologist should be familiar with the imaging findings and clinical features of this potentially fatal complication.