A patient was referred to my neurology clinic by a very junior emergency doctor who had made an impression of TIA (transient ischaemic attack) involving veterobasillar insufficiency. On further questioning, he had complained of unsteady gait, seeing "double" when looking to the left and slight reduction in hearing abilities. He had lateral rectus palsy (6th cranial nerve) and he manifested left cerebellar signs. Even without an MRI scan , i already can predict this is a problem with lesion in cerebello-pontine.
I was called by a radiologist 3 days later to inform my already expected findings of this benign tumour called ACOUSTIC NEUROMA.,.. or the other name for it...VESTIBULAR SCHWANNOMA. .. A semi-urgent referrral to Penang GH for neurosurgical intervention was made then.
This tumour is associated with Neurofibromatosis Type II.
To junior doctors, be precise in history taking and physical examination to get a proper diagnosis , after all our job acquired us to do so...