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A Unified Methodological Framework for Vestibular Schwannoma Research
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Vestibular schwannoma causing normal pressure hydrocephalus.

Alexander Hayes1, Mark Wilson2, Anastassia Gontsarova3

  • 1Imperial College London, Department of Brain Sciences, London, UK alex-hayes@outlook.com.

Practical Neurology
|August 22, 2024
PubMed
Summary

Vestibular schwannoma, a benign tumor, can cause communicating hydrocephalus. This case report highlights improved symptoms in a patient with elevated cerebrospinal fluid protein after shunt insertion, suggesting impaired CSF resorption.

Keywords:
CLINICAL NEUROLOGYGAITNEURORADIOLOGYNEUROSURGERYSCHWANN CELL

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Area of Science:

  • Neurology
  • Neurosurgery
  • Oncology

Background:

  • Vestibular schwannoma is a common, benign tumor.
  • It can lead to local complications, including communicating hydrocephalus.
  • Communicating hydrocephalus associated with vestibular schwannoma often presents with normal pressure hydrocephalus symptoms.

Purpose of the Study:

  • To report a case of vestibular schwannoma associated with communicating hydrocephalus.
  • To discuss the potential mechanism of hydrocephalus in this context.
  • To highlight the clinical presentation and management of such cases.

Main Methods:

  • Case report of a 79-year-old woman.
  • Diagnostic imaging included CT and MR.
  • Cerebrospinal fluid (CSF) analysis was performed.
  • Treatment involved ventriculoperitoneal shunt insertion.

Main Results:

  • A 20 mm vestibular schwannoma and communicating hydrocephalus were identified.
  • The patient presented with gait apraxia, cognitive impairment, and urinary incontinence.
  • Elevated CSF protein levels were noted.
  • Symptoms improved after ventriculoperitoneal shunt insertion.

Conclusions:

  • Vestibular schwannoma can cause communicating hydrocephalus, even when non-obstructing.
  • Elevated CSF protein (hyperproteinorrachia) may impede CSF resorption, contributing to hydrocephalus.
  • Symptomatic relief can be achieved with CSF diversion via shunting.