Access to this article is restricted until 6 months after publication by request of the publisher.. Restriction lift date: 2021-06-12
'Should have gone to...': bilateral papilloedema with normal CSF pressure due to vestibular schwannoma
Loading...
Files
Accepted Version
CT marked 300
MRI 300
Date
2020-12-12
Authors
Ronan, Geoffrey Peter
Gailani, Gaafar
Costello, Ciara
Sweeney, Brian
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Published Version
Abstract
A 24-year-old woman presented with bilateral blurring of her distance vision and 'dizzy spells'. She had no other neurological symptoms or medical history. She consulted an optometrist, and optical coherence tomography (OCT) was performed, which demonstrated papilloedema. She was referred to the local eye clinic for assessment and from there was referred for neurological assessment.Her initial investigations revealed no abnormalities, and brain imaging was reported to be normal. In the absence of an alternative diagnosis, idiopathic intracranial hypertension (IIH) was considered and a lumbar puncture was performed. This showed elevated protein but normal cerebrospinal fluid (CSF) pressure. MRI of the brain the next day revealed a large cerebellopontine lesion in keeping with vestibular schwannoma. She was referred to neurosurgery for operative management.This case highlights three interesting points: the aetiology of her papilloedema without raised intracranial pressure, the decision to perform a lumbar puncture in suspected IIH and community OCT as a clinical adjunct.
Description
Keywords
Bilateral papilloedema , Idiopathic intracranial hypertension , Lumbar puncture
Citation
Ronan, G. P., Gailani, G., Costello, C. and Sweeney, B. (2020) 'Should have gone to...': bilateral papilloedema with normal CSF pressure due to vestibular schwannoma', BMJ case reports, 13(12), e239406 (3pp). doi: 10.1136/bcr-2020-239406