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Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study

Bilateral papilledema secondary to obstructive or communicating hydrocephalus in patients with vestibular schwannomas is a known presentation; however, papilledema in the absence of hydrocephalus is rarely reported and its mechanism is poorly understood. We report a case of a 20-year-old woman prese...

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Autores principales: Candanedo, Carlos, Moscovici, Samuel, Kruger, Joshua M, Mizrachi, Cezar J, Eliahou, Ruth, Spektor, Sergey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773271/
https://www.ncbi.nlm.nih.gov/pubmed/29375948
http://dx.doi.org/10.7759/cureus.1862
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author Candanedo, Carlos
Moscovici, Samuel
Kruger, Joshua M
Mizrachi, Cezar J
Eliahou, Ruth
Spektor, Sergey
author_facet Candanedo, Carlos
Moscovici, Samuel
Kruger, Joshua M
Mizrachi, Cezar J
Eliahou, Ruth
Spektor, Sergey
author_sort Candanedo, Carlos
collection PubMed
description Bilateral papilledema secondary to obstructive or communicating hydrocephalus in patients with vestibular schwannomas is a known presentation; however, papilledema in the absence of hydrocephalus is rarely reported and its mechanism is poorly understood. We report a case of a 20-year-old woman presenting with visual deterioration and bilateral papilledema on fundoscopy. Magnetic resonance imaging (MRI) revealed a giant vestibular schwannoma with no sign of hydrocephalus. The only imaging evidence of increased pressure on preoperative imaging studies was seen on a T2-weighted MRI, where there was subtle dilatation of the arachnoid space of the optic sleeve. We presume that this patient developed papilledema by some mechanism not connected to hydrocephalus. In a young patient, papilledema may be a sign preceding hydrocephalus, or she may have had pseudotumor cerebri concomitant with her vestibular schwannoma. In either case, removal of the vestibular schwannoma solved the problem. She had complete visual recovery, irrespective of the mechanism.
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spelling pubmed-57732712018-01-28 Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study Candanedo, Carlos Moscovici, Samuel Kruger, Joshua M Mizrachi, Cezar J Eliahou, Ruth Spektor, Sergey Cureus Ophthalmology Bilateral papilledema secondary to obstructive or communicating hydrocephalus in patients with vestibular schwannomas is a known presentation; however, papilledema in the absence of hydrocephalus is rarely reported and its mechanism is poorly understood. We report a case of a 20-year-old woman presenting with visual deterioration and bilateral papilledema on fundoscopy. Magnetic resonance imaging (MRI) revealed a giant vestibular schwannoma with no sign of hydrocephalus. The only imaging evidence of increased pressure on preoperative imaging studies was seen on a T2-weighted MRI, where there was subtle dilatation of the arachnoid space of the optic sleeve. We presume that this patient developed papilledema by some mechanism not connected to hydrocephalus. In a young patient, papilledema may be a sign preceding hydrocephalus, or she may have had pseudotumor cerebri concomitant with her vestibular schwannoma. In either case, removal of the vestibular schwannoma solved the problem. She had complete visual recovery, irrespective of the mechanism. Cureus 2017-11-20 /pmc/articles/PMC5773271/ /pubmed/29375948 http://dx.doi.org/10.7759/cureus.1862 Text en Copyright © 2017, Candanedo et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Ophthalmology
Candanedo, Carlos
Moscovici, Samuel
Kruger, Joshua M
Mizrachi, Cezar J
Eliahou, Ruth
Spektor, Sergey
Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title_full Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title_fullStr Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title_full_unstemmed Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title_short Vestibular Schwannoma Presenting with Bilateral Papilledema Without Hydrocephalus: Case Study
title_sort vestibular schwannoma presenting with bilateral papilledema without hydrocephalus: case study
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773271/
https://www.ncbi.nlm.nih.gov/pubmed/29375948
http://dx.doi.org/10.7759/cureus.1862
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