{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:44:50Z","timestamp":1755798290658,"version":"3.44.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fonc.2025.1448374","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T05:20:27Z","timestamp":1755580827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vestibular schwannomas and papilledema without hydrocephalus: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Roberto","family":"Calder\u00f3n-Moreno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"No\u00e9","family":"P\u00e9rez Carrillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 de Jes\u00fas","family":"Mart\u00ednez-Manrique","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12112776","article-title":"The diagnostic accuracy of pure-tone audiometry screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss\u2014A systematic review and meta-analysis","volume":"12","author":"Gheorghe","year":"2022","journal-title":"Diagnostics"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211042006","article-title":"Global incidence of sporadic vestibular schwannoma: A systematic review","volume":"167","author":"Marinelli","year":"2021","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-002-1021-7","article-title":"Non-obstructive hydrocephalus associated with intracranial schwannomas: hyperproteinorrhachia as an etiopathological factor","volume":"145","author":"Bloch","year":"2003","journal-title":"Acta Neurochir"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.931523","article-title":"Cerebrospinal fluid dynamics along the optic nerve","volume":"13","author":"Sheng","year":"2022","journal-title":"Front Neurol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2022.952036","article-title":"The pathogenesis of idiopathic normal pressure hydrocephalus based on the understanding of AQP1 and AQP4","volume":"15","author":"Zhao","year":"2022","journal-title":"Front Mol Neurosci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.exer.2016.04.013","article-title":"Aquaporin expression and localization in the rabbit eye","volume":"147","author":"Bogner","year":"2016","journal-title":"Exp Eye Res"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11010032","article-title":"Tumor biology and microenvironment of vestibular schwannoma-relation to tumor growth and hearing loss","volume":"11","author":"Tesa\u0159ov\u00e1","year":"2022","journal-title":"Biomed"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1756633","article-title":"Preoperative visual impairment in vestibular schwannoma patients: an overlooked entity of developing world","volume":"17","author":"Kumar","year":"2022","journal-title":"Asian J Neurosurg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-012-1529-4","article-title":"Large and giant vestibular schwannomas: does cisterna magna hyperproteinorrhachia influence visual status","volume":"155","author":"Kumar","year":"2013","journal-title":"Acta Neurochir"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15732","article-title":"Optic nerve sheath diameter ultrasound for raised intracranial pressure","volume":"41","author":"Aletreby","year":"2022","journal-title":"J Ultrasound Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-868165","article-title":"Case report: optic disc edema without hydrocephalus in acoustic neuroma","volume":"15","author":"Grainger","year":"2005","journal-title":"Skull Base"},{"key":"B12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3892\/ol.2012.1011","article-title":"Clinical features of intracranial vestibular schwannomas","volume":"5","author":"Huang","year":"2013","journal-title":"Oncol Lett"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.1862","article-title":"Vestibular schwannoma presenting with bilateral papilledema without hydrocephalus: case study","volume":"9","author":"Candanedo","year":"2017","journal-title":"Cureus"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuchi.2021.04.017","article-title":"Papilledema secondary to vestibular schwannoma: An atypical case without intracranial hypertension","volume":"68","author":"Gavotto","year":"2022","journal-title":"Neurochirurgie"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1080\/01658107.2016.1183133","article-title":"Advanced vestibular schwannoma: A case of optic disc oedema without hydrocephalus","volume":"40","author":"Matos","year":"2016","journal-title":"Neuro-ophthalmology"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/s0021-5155(98)00027-6","article-title":"Severe optic disc edema without hydrocephalus in neurofibromatosis 2","volume":"42","author":"Harada","year":"1998","journal-title":"Jpn J Ophthalmol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1093\/noajnl\/vdaa023","article-title":"The inflammatory microenvironment in vestibular schwannoma","volume":"2","author":"Hannan","year":"2020","journal-title":"Neurooncol Adv"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.24915","article-title":"Optic disc edema and elevated intracranial pressure (ICP): A comprehensive review of papilledema","volume":"14","author":"Reier","year":"2022","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","first-page":"147ra111","DOI":"10.1126\/scitranslmed.3003748","article-title":"A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid \u03b2","volume":"4","author":"Iliff","year":"2012","journal-title":"Sci Transl Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1126\/science.adc8810","article-title":"A mesothelium divides the subarachnoid space into functional compartments","volume":"379","author":"M\u00f8llg\u00e5rd","year":"2023","journal-title":"Science"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/6413553","article-title":"Progress on brain and ocular lymphatic system","volume":"2022","author":"Xu","year":"2022","journal-title":"BioMed Res Int"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1448374\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T05:20:28Z","timestamp":1755580828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1448374\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":21,"alternative-id":["10.3389\/fonc.2025.1448374"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1448374","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2025,8,19]]},"article-number":"1448374"}}