[Case of hydrocephalus associated with vestibular schwannoma, treated by tumor removal]

A 57-year-old male presented with gait disturbance, urinary incontinence, dementia resembling symptom of normal pressure hydrocephalus (NPH) and was admitted to our institusion. A computerized tomographic scan (CT) and magnetic resonance imaging (MRI) revealed hydrocephalus as well as a tumor in the right cerebellopontine angle. We diagnosed communicating-type hydrocephalus associated with the vestibular schwannoma and tumor removal was performed prior to ventriculo-peritoneal (V-P) shunt. After surgery, symptoms of the patient disappeared promptly and cerebrospinal fluid protein elevation was normalized. One month after surgery, CT and MRI revealed reduction of the ventricle size and V-P shunt became unnecessary. Hydrocephalus is occasionally complicated by vestibular schwannoma. The majority results from obstruction of the cerebrospinal fluid (CSF) pathway by large tumors. But, small tumors also cause communicating-type hydrocephalus. Although the selection of the treatment is controversial, tumor removal without a shunt is considered as a good strategy for management of hydrocephalus associated with vestibular schwannoma.