Abstract
Background Large vestibular schwannomas (VSs) can cause hydrocephalus by obstructing the fourth
ventricle. Little is known about the communicating hydrocephalus that is seen with
a smaller VS.
Methods The clinicopathological findings and follow up of three patients with communicating
hydrocephalus associated with a small VS are presented.
Results Four patients aged 40 to 66 years (mean: 57.7) presented with ataxia, dementia, and
urinary incontinence. The VS were 2.0 to 2.4 cm. The cerebrospinal fluid (CSF) protein
was elevated in three patients in whom it was measured (1.7 to 6 times normal). The
VS was resected in two patients. All of the patients required ventriculoperitoneal
shunting (VPS). All of the patients were asymptomatic or improved at follow-up at
9 months to 13 years.
Conclusion Communicating hydrocephalus associated with a VS can occur in younger patients than
was previously thought. An elevated CSF protein appears to be important, but other
factors may be involved. A shunting procedure is often required to relieve the symptoms
of hydrocephalus even if the tumor is resected. Possible etiological causes of communicating
hydrocephalus in patients with a small VS are discussed.
Keywords
vestibular schwannoma - communicating hydrocephalus