Service de neurochirurgie, hôpital Pasteur 2, CHU de Nice, 30, avenue de la voie romaine, 06000 Nice, France; Université Côte d'Azur, Nice, France.
Université Côte d'Azur, Nice, France; Service d'ophtalmologie, hôpital Pasteur 2, Nice, France.
Neurochirurgie. 2022 Apr;68(3):327-330. doi: 10.1016/j.neuchi.2021.04.017. Epub 2021 May 11.
In most cases, vestibular schwannomas with papilledema are associated with intracranial hypertension secondary to hydrocephalus (obstructive or communicating). We describe the atypical case of a 39-years-old man who presented with bilateral papilledema revealing a vestibular schwannoma, but without hydrocephalus and with normal intracranial pressure. Ophtalmologic signs were completely resolved after tumor removal. The pathophysiological mechanism generally described to explain bilateral papilledema in such cases is tumor-induced hyperproteinorachia. However, in the absence of hydrocephalus or intracranial hypertension, this case raises the question of the mechanisms involved in the visual impairment related to vestibular schwannoma.
在大多数情况下，伴有视乳头水肿的前庭神经鞘瘤与脑积水（梗阻性或交通性）引起的颅内高压有关。我们描述了一个不典型的病例，一名 39 岁男性出现双侧视乳头水肿，提示存在前庭神经鞘瘤，但没有脑积水和正常颅内压。肿瘤切除后，眼科体征完全消退。一般来说，这种情况下双侧视乳头水肿的病理生理机制被描述为肿瘤引起的高蛋白血症。然而，在没有脑积水或颅内高压的情况下，这种情况提出了与前庭神经鞘瘤相关的视力损害相关的机制问题。
