Post-papilledema optic atrophy without hydrocephalus in vestibular schwannoma: A case report

Vishwanath Sahukar Eshwarappa; Sudakshina Nathan; K. Chandrasekar; Balamurugan Mangaleshwaran

doi:10.15562/ijn.v5i3.199

Post-papilledema optic atrophy without hydrocephalus in vestibular schwannoma: A case report

Vishwanath Sahukar Eshwarappa ,

Sudakshina Nathan ,

K. Chandrasekar ,

Balamurugan Mangaleshwaran ,

pdf |
DOI: https://doi.org/10.15562/ijn.v5i3.199 |
Published: 2022-09-02

Abstract

Background: Vestibular schwannoma is the most common lesion of the cerebellopontine angle and accounts for 90% of all conditions affecting the cerebellopontine angle and 8% of all intracranial primary neoplasm. It is a benign, slow-growing tumor of Schwann cell origin.

Case presentation: A 30-year-old lady, with no significant medical history presented with chief complaints of progressive visual deterioration in both eyes for the past month, which was insidious in onset gradually progressive, and not associated with headache, vomiting, giddiness, or diplopia. There was no history of floaters, narrowing of the visual field, pain, or redness in the eyes.

Conclusion: Vestibular schwannoma presenting as severe vision loss is rare. There are different causes for papilledema in vestibular schwannoma. Early detection and treatment of papilledema will help to restore vision.

Keywords: case report; treatment of papilledema; vestibular schwannoma; visual deterioration

References

Komatsuzaki A, Tsunoda A. Nerve origin of the acoustic neuroma. J Laryngol Otol. 2001 May;115(5):376-9. doi: 10.1258/0022215011907910. PMID: 11410128.
Pinna MH, Bento RF, Neto RV. Vestibular schwannoma: 825 cases from a 25-year experience. Int Arch Otorhinolaryngol. 2012 Oct;16(4):466-75. doi: 10.7162/S1809-97772012000400007. PMID: 25991975; PMCID: PMC4435437.
Cushing H. Tumors of the nervus acusticus and the syndrome of cerebellopontine angle, Philadelphia, Saunders, edit., 1917
Woodford S. Van Meter, Brian R. Younge, Stephen G. Harner. Ophthalmic Manifestations of Acoustic Neurinoma, Ophthalmology, Volume 90, Issue 8, 1983, Pages 917-922,
Rogg, J.M., Ahn, S.H., Tung, G.A. et al. Prevalence of hydrocephalus in 157 patients with vestibular schwannoma. Neuroradiology 47, 344–351 (2005).
Rigi M, Almarzouqi SJ, Morgan ML, Lee AG. Papilledema: epidemiology, etiology, and clinical management. Eye Brain. 2015 Aug 17;7:47-57. doi: 10.2147/EB.S69174. PMID: 28539794; PMCID: PMC5398730.
Matos RJ, Gil PN, Pires JM, Lopes N. Advanced Vestibular Schwannoma: A Case of Optic Disc Oedema without Hydrocephalus. Neuroophthalmology. 2016 May 27;40(5):222-224. doi: 10.1080/01658107.2016.1183133. PMID: 27928409; PMCID: PMC5123157.
‘Ronan GP, Gailani G, Costello C, Sweeney B. 'Should have gone to …': bilateral papilloedema with normal CSF pressure due to vestibular schwannoma. BMJ Case Rep. 2020 Dec 12;13(12):e239406. doi: 10.1136/bcr-2020-239406. PMID: 33310837; PMCID: PMC7735114.
Harada T, Sawamura Y, Ohashi T, Harada C, Shinmei Y, Yoshida K, Matsuda H. Severe optic disc edema without hydrocephalus in neurofibromatosis 2. Jpn J Ophthalmol. 1998 Sep-Oct;42(5):381-4. doi: 10.1016/s0021-5155(98)00027-6. PMID: 9822967.
Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol. 2006 May;5(5):433-42. doi: 10.1016/S1474-4422(06)70442-2. PMID: 16632314.
Grainger J, Dias PS. Case report: optic disc edema without hydrocephalus in acoustic neuroma. Skull Base. 2005 Feb;15(1):83-6; discussion 86-8. doi: 10.1055/s-2005-868165. PMID: 16148986; PMCID: PMC1151706.
Kumar B, Behari S, Jaiswal AK, Jha VK, Bettaswamy G, Singh U. Large and giant vestibular schwannomas: does cisterna magna hyperproteinorrhachia influence visual status? Acta Neurochir (Wien). 2013 Jan;155(1):63-9. doi: 10.1007/s00701-012-1529-4. Epub 2012 Nov 8. PMID: 23135066.
Cauley KA, Ratkovits B, Braff SP, Linnell G. Communicating hydrocephalus after gamma knife radiosurgery for vestibular schwannoma: an MR imaging study. AJNR Am J Neuroradiol. 2009 May;30(5):992-4. doi: 10.3174/ajnr.A1379. Epub 2008 Nov 27. PMID: 19039040; PMCID: PMC7051663..
Jefferis JM, Raoof N, Carroll T, Salvi SM. Optic nerve sheath fenestration in patients with visual failure associated with vestibular schwannoma. Br J Neurosurg. 2019 Aug;33(4):402-408. doi: 10.1080/02688697.2018.1538482. Epub 2019 Mar 4. PMID: 30829548.

[1] Komatsuzaki A, Tsunoda A. Nerve origin of the acoustic neuroma. J Laryngol Otol. 2001 May;115(5):376-9. doi: 10.1258/0022215011907910. PMID: 11410128.

[2] Pinna MH, Bento RF, Neto RV. Vestibular schwannoma: 825 cases from a 25-year experience. Int Arch Otorhinolaryngol. 2012 Oct;16(4):466-75. doi: 10.7162/S1809-97772012000400007. PMID: 25991975; PMCID: PMC4435437.

[3] Cushing H. Tumors of the nervus acusticus and the syndrome of cerebellopontine angle, Philadelphia, Saunders, edit., 1917

[4] Woodford S. Van Meter, Brian R. Younge, Stephen G. Harner. Ophthalmic Manifestations of Acoustic Neurinoma, Ophthalmology, Volume 90, Issue 8, 1983, Pages 917-922,

[5] Rogg, J.M., Ahn, S.H., Tung, G.A. et al. Prevalence of hydrocephalus in 157 patients with vestibular schwannoma. Neuroradiology 47, 344–351 (2005).

[6] Rigi M, Almarzouqi SJ, Morgan ML, Lee AG. Papilledema: epidemiology, etiology, and clinical management. Eye Brain. 2015 Aug 17;7:47-57. doi: 10.2147/EB.S69174. PMID: 28539794; PMCID: PMC5398730.

[7] Matos RJ, Gil PN, Pires JM, Lopes N. Advanced Vestibular Schwannoma: A Case of Optic Disc Oedema without Hydrocephalus. Neuroophthalmology. 2016 May 27;40(5):222-224. doi: 10.1080/01658107.2016.1183133. PMID: 27928409; PMCID: PMC5123157.

[8] ‘Ronan GP, Gailani G, Costello C, Sweeney B. 'Should have gone to …': bilateral papilloedema with normal CSF pressure due to vestibular schwannoma. BMJ Case Rep. 2020 Dec 12;13(12):e239406. doi: 10.1136/bcr-2020-239406. PMID: 33310837; PMCID: PMC7735114.

[9] Harada T, Sawamura Y, Ohashi T, Harada C, Shinmei Y, Yoshida K, Matsuda H. Severe optic disc edema without hydrocephalus in neurofibromatosis 2. Jpn J Ophthalmol. 1998 Sep-Oct;42(5):381-4. doi: 10.1016/s0021-5155(98)00027-6. PMID: 9822967.

[10] Ball AK, Clarke CE. Idiopathic intracranial hypertension. Lancet Neurol. 2006 May;5(5):433-42. doi: 10.1016/S1474-4422(06)70442-2. PMID: 16632314.

[11] Grainger J, Dias PS. Case report: optic disc edema without hydrocephalus in acoustic neuroma. Skull Base. 2005 Feb;15(1):83-6; discussion 86-8. doi: 10.1055/s-2005-868165. PMID: 16148986; PMCID: PMC1151706.

[12] Kumar B, Behari S, Jaiswal AK, Jha VK, Bettaswamy G, Singh U. Large and giant vestibular schwannomas: does cisterna magna hyperproteinorrhachia influence visual status? Acta Neurochir (Wien). 2013 Jan;155(1):63-9. doi: 10.1007/s00701-012-1529-4. Epub 2012 Nov 8. PMID: 23135066.

[13] Cauley KA, Ratkovits B, Braff SP, Linnell G. Communicating hydrocephalus after gamma knife radiosurgery for vestibular schwannoma: an MR imaging study. AJNR Am J Neuroradiol. 2009 May;30(5):992-4. doi: 10.3174/ajnr.A1379. Epub 2008 Nov 27. PMID: 19039040; PMCID: PMC7051663..

[14] Jefferis JM, Raoof N, Carroll T, Salvi SM. Optic nerve sheath fenestration in patients with visual failure associated with vestibular schwannoma. Br J Neurosurg. 2019 Aug;33(4):402-408. doi: 10.1080/02688697.2018.1538482. Epub 2019 Mar 4. PMID: 30829548.

Post-papilledema optic atrophy without hydrocephalus in vestibular schwannoma: A case report

Abstract

References

How to Cite

Search Panel