We present a very unusual case of an acoustic neuroma involving the le
ft cochlea and internal auditory canal of a 24-year-old man. Clinical
suspicion was aroused when the patient presented with a left total sen
sorineural hearing loss and continuing vertigo, The diagnosis was made
pre-operatively with MRI after initial CT scanning was normal. The tu
mour was removed via a transotic approach. This case report demonstrat
es the MRI features of an intracochlear schwannoma and emphasizes the
importance of MRI in patients with significant auditory and clinical a
bnormalities with normal CT scans of the relevant region.