ataxic gait, nystagmus - nida

[ArchivalUser]

A 65-year-old widow presents with a 6-month history
of unsteadiness. She has started to veer to the left. She
has been well prior to this, apart from a longstanding
hearing problem and surgery for colon cancer 5 years
ago. On examination she has an ataxic gait, slight
leftwards nystagmus, an absent left corneal reflex
and marked left-sided deafness.There is no
papilloedema.

What do you think is the cause of her symptoms?

[ArchivalUser]

cerebellar hemorhage??

[ArchivalUser]

She has signs of a lesion in the left cerebellopontine angle,
with ataxia, loss of the corneal reflex (cranial nerve 5) and
deafness (cranial nerve 8). It has come on slowly, starting
with deafness, so it is more likely to be an acoustic neuroma
than a metastasis from her previous cancer.
An MR scan confirmed this. The neuroma was too large
to treat with radiotherapy but was successfully removed,
giving her a transient left facial weakness (cranial nerve 7)
and permanent complete left deafness.

[ArchivalUser]

Brain Mets, is my answer always suspect, presentation is not sigled out to a territory of blood supply

It can be infarction if it is hemorhage patients , present pretty badly