Papilledema as the presenting manifestation of spinal schwannoma

Fiona Costello, Randy H. Kardon, Michael Wall, Patricia Kirby, Timothy Ryken, Andrew G. Lee

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


A 63-year-old woman with headache, blurred vision, bilateral optic disc edema, and normal cranial magnetic resonance imaging scan underwent lumbar puncture that revealed an elevated opening pressure (290 mm water), a protein level of 114 mg/dl, and mild pleocytosis. Spinal magnetic resonance imaging later demonstrated a sacral tumor, which proved to be a schwannoma with sarcoid-like features. After surgical removal of the tumor, the patient's manifestations resolved. This case emphasizes that low spinal cord tumors can cause elevated intracranial pressure without causing markedly elevated cerebrospinal fluid protein or cells, or any myelopathic manifestations, perhaps by obstructing sacral cerebrospinal drainage. Comprehensive spine imaging should be a part of the evaluation of a patient with papilledema who has normal brain imaging but abnormal spinal fluid constituents.

Original languageEnglish (US)
Pages (from-to)199-203
Number of pages5
JournalJournal of Neuro-Ophthalmology
Issue number3
StatePublished - Sep 2002

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology


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