Vestibular Schwannomas: A Narrative Review on Imaging and Treatment Perspectives

Vestibular schwannomas, the predominant neoplasms within the cerebellopontine angle, have experienced an evolution in therapeutic objectives over the last century, transitioning from the goal of total excision to one of functional preservation. Present-day treatment modalities encompass surgical resection, stereotactic radiosurgery, and observation. Imaging is pivotal for the initial screening, thorough evaluation, and ongoing assessment of vestibular schwannomas. Radiologists, by discerning and understanding management goals, treatment methodologies, anticipated post-treatment results, and potential complications, play an integral role in multidisciplinary medical teams. Their expertise yields essential insights for planning treatment and evaluating outcomes. The authors present an extensive discussion that includes surgical management, the role of radiation therapy, observation strategies, imaging differentials, and both pre- and post-treatment imaging findings pertinent to vestibular schwannomas.