Vestibular schwannoma causing normal pressure hydrocephalus.

Vestibular schwannoma is a common benign tumour that may cause local complications. However, vestibular schwannoma has a known association with communicating hydrocephalus presenting with symptoms of normal pressure hydrocephalus and requiring treatment by ventricular shunting or tumour resection. We report a 79-year-old woman who presented with subacute gait apraxia, cognitive impairment and urinary incontinence. CT and MR imaging identified a 20 mm vestibular schwannoma and communicating hydrocephalus; her cerebrospinal fluid (CSF) protein was elevated. Her symptoms improved following ventriculoperitoneal shunt insertion. The mechanism by which non-obstructing vestibular schwannoma causes hydrocephalus is unclear, but hyperproteinorrachia is probably important, likely by impeding CSF resorption.

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Déclaration de conflit d'intérêts

Competing interests: AH, MW and AG have no disclosures. CC holds an MRC-CARP Grant to investigate the cause of shunt-responsiveness in normal pressure hydrocephalus (NPH), is the chair of the ABN NPH Specialist Interest Group and holds a 1% share in the HCA-Chiswick Medical Centre.