Vestibular schwannomas and papilledema without hydrocephalus: a case report

Vestibular Schwannomas are frequent tumors of the cerebellopontine angle, classically presenting with cochlear and facial nerve alteration. They tend to have histopathological and intratumoral degeneration seen on MRI, and can cause CSF obstruction with hydrocephalus with subsequent visual loss. We...

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Main Authors: Roberto Calderón-Moreno, Noé Pérez Carrillo, José de Jesús Martínez-Manrique
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1448374/full
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author Roberto Calderón-Moreno
Noé Pérez Carrillo
José de Jesús Martínez-Manrique
author_facet Roberto Calderón-Moreno
Noé Pérez Carrillo
José de Jesús Martínez-Manrique
author_sort Roberto Calderón-Moreno
collection DOAJ
description Vestibular Schwannomas are frequent tumors of the cerebellopontine angle, classically presenting with cochlear and facial nerve alteration. They tend to have histopathological and intratumoral degeneration seen on MRI, and can cause CSF obstruction with hydrocephalus with subsequent visual loss. We present a case of bilateral visual loss from papilledema, with no history of hydrocephalus or increased intracranial pressure. CSF analysis showed isolated hyperproteinorrachia with no sign of infection or meningitis. This case report reviews current understanding of CSF physiology, including flow within the optic nerve sheath, which is a CSF reservoir with outflow through the complex glymphatic system. Multiple aquaporins regulate optic nerve CSF flow, responsible for the intense metabolic product washdown from the retinal apparatus. Aquaporin activity is susceptible to up-regulation or down-regulation from CSF content, such as in the complexity of certain Vestibular Schwannomas, as seen on molecular and histopathological analysis in other studies.
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spelling doaj-art-cf14950a27884a64a691c3fa47fda65d2025-08-20T03:47:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.14483741448374Vestibular schwannomas and papilledema without hydrocephalus: a case reportRoberto Calderón-MorenoNoé Pérez CarrilloJosé de Jesús Martínez-ManriqueVestibular Schwannomas are frequent tumors of the cerebellopontine angle, classically presenting with cochlear and facial nerve alteration. They tend to have histopathological and intratumoral degeneration seen on MRI, and can cause CSF obstruction with hydrocephalus with subsequent visual loss. We present a case of bilateral visual loss from papilledema, with no history of hydrocephalus or increased intracranial pressure. CSF analysis showed isolated hyperproteinorrachia with no sign of infection or meningitis. This case report reviews current understanding of CSF physiology, including flow within the optic nerve sheath, which is a CSF reservoir with outflow through the complex glymphatic system. Multiple aquaporins regulate optic nerve CSF flow, responsible for the intense metabolic product washdown from the retinal apparatus. Aquaporin activity is susceptible to up-regulation or down-regulation from CSF content, such as in the complexity of certain Vestibular Schwannomas, as seen on molecular and histopathological analysis in other studies.https://www.frontiersin.org/articles/10.3389/fonc.2025.1448374/fullschwannomapapilledemaCSF (cerebrospinal fluid)glymphatic circulationoptic nerve sheath compartment
spellingShingle Roberto Calderón-Moreno
Noé Pérez Carrillo
José de Jesús Martínez-Manrique
Vestibular schwannomas and papilledema without hydrocephalus: a case report
Frontiers in Oncology
schwannoma
papilledema
CSF (cerebrospinal fluid)
glymphatic circulation
optic nerve sheath compartment
title Vestibular schwannomas and papilledema without hydrocephalus: a case report
title_full Vestibular schwannomas and papilledema without hydrocephalus: a case report
title_fullStr Vestibular schwannomas and papilledema without hydrocephalus: a case report
title_full_unstemmed Vestibular schwannomas and papilledema without hydrocephalus: a case report
title_short Vestibular schwannomas and papilledema without hydrocephalus: a case report
title_sort vestibular schwannomas and papilledema without hydrocephalus a case report
topic schwannoma
papilledema
CSF (cerebrospinal fluid)
glymphatic circulation
optic nerve sheath compartment
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1448374/full
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