CN VIII Pathology

Petrous fractures that involve CNVIII result in hearing loss, vertigo and nystagmus (frequently positional) immediately after the injury. Severe middle ear infection can cause similar symptoms but have a more gradual onset. Acoustic neuroma is associated with gradual ipsilateral hearing loss. Due to the close proximity CN VII and CN VIII, acoustic neuromas often present with involvement of the facial nerve. Neurofibromatosis type II is associated with bilateral acoustic neuromas. Vertigo may be associated with anything that compresses the nerve including vascular abnormalities, inflammation and neoplasm.