Harada T, Sawamura Y, Ohashi T, Harada C, Shinmei Y, Yoshida K, Matsuda H
Department of Ophthalmology, Hokkaido University School of Medicine, Sapporo, Japan.
Jpn J Ophthalmol. 1998 Sep-Oct;42(5):381-4. doi: 10.1016/s0021-5155(98)00027-6.
A 26-year-old man who had neurofibromatosis type-2 with symptoms of unexplained optic disc edema is reported. Magnetic resonance imaging (MRI) revealed bilateral acoustic schwannomas. Obstructive hydrocephalus, however, was not evident in spite of his severe disc edema and visual loss. After partial removal of the right acoustic schwannoma, symptoms of intracranial hypertension, such as vomiting and headache, developed and MRI demonstrated evidence of obstructive hydrocephalus. Placement of a ventricular-peritoneal shunt relieved the symptoms of intracranial hypertension, but visual acuity in his left eye was reduced to hand motion due to secondary optic atrophy. In patients with similar symptoms it is suggested that, in addition to tumor removal, early treatment to decrease intracranial pressure should be considered when visual function is progressively impaired by the symptoms of prolonged papilledema.
报告了一名26岁患有2型神经纤维瘤病且有不明原因视盘水肿症状的男性。磁共振成像（MRI）显示双侧听神经鞘瘤。然而，尽管他有严重的视盘水肿和视力丧失，但梗阻性脑积水并不明显。在部分切除右侧听神经鞘瘤后，出现了颅内高压症状，如呕吐和头痛，MRI显示有梗阻性脑积水的证据。脑室-腹腔分流术缓解了颅内高压症状，但由于继发性视神经萎缩，他左眼的视力降至手动。对于有类似症状的患者，建议除了切除肿瘤外，当视功能因长期视乳头水肿症状而逐渐受损时，应考虑早期降低颅内压的治疗。
