Nakahara Masahiro, Imahori Taichiro, Sasayama Takashi, Nakai Tomoaki, Taniguchi Masaaki, Komatsu Masato, Kanzawa Maki, Kohmura Eiji
Department of Neurosurgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
Radiol Case Rep. 2020 May 15;15(7):1023-1028. doi: 10.1016/j.radcr.2020.04.063. eCollection 2020 Jul.
Communicating hydrocephalus is a known tumor-related syndrome associated with vestibular schwannoma, which can occur even in small tumor. Radiation has become a popular primary treatment option for small schwannoma; however, little is known about the efficacy and risk accompanying asymptomatic ventriculomegaly on images. We report a case of a 59-year-old woman who suffer from refractory communicating hydrocephalus after radiation for small vestibular schwannoma with asymptomatic ventriculomegaly. After the surgical removal of the tumor, hydrocephalus was gradually improved due to intermittent lumbar puncture and finally resolved without shunt placement. Surgical removal should be considered as the first option for the treatment, even if the patient is asymptomatic and the images revealed a small vestibular schwannoma with only slight ventricular enlargement.
交通性脑积水是一种已知的与前庭神经鞘瘤相关的肿瘤综合征，即使在小肿瘤中也可能发生。放射治疗已成为小神经鞘瘤的一种常用主要治疗选择；然而，对于影像上无症状脑室扩大的疗效和风险知之甚少。我们报告一例59岁女性，她在接受放射治疗后因小前庭神经鞘瘤伴无症状脑室扩大而患有难治性交通性脑积水。手术切除肿瘤后，通过间歇性腰椎穿刺，脑积水逐渐改善，最终无需放置分流管即得以解决。即使患者无症状且影像显示为仅伴有轻微脑室扩大的小前庭神经鞘瘤，手术切除也应被视为治疗的首选方案。
