Vestibular schwannoma (VS) is commonly associated with obstructive hydrocephalus due to mass effect; however, a rarer communicating form resembling normal pressure hydrocephalus (NPH) has also been described, possibly related to impaired CSF absorption from elevated CSF protein....
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists should be aware that vestibular schwannoma patients can develop NPH, as this may influence referral pathways, but direct clinical practice change for audiology is limited — this is primarily a neurosurgical concern.
Recognizing that vestibular schwannoma can trigger NPH expands the differential diagnosis for balance and cognitive symptoms in this patient population, with implications for neurotology referral and multidisciplinary care.
- 01Vestibular schwannoma can be associated with normal pressure hydrocephalus (NPH), a brain fluid condition.
- 02Study retrospectively compared VS-associated NPH with idiopathic (unknown cause) NPH.
- 03Shunt responsiveness (how well the drainage tube worked) was compared between the two groups.
- 04Findings have implications for neurosurgical management of vestibular schwannoma patients.
- 05Retrospective design limits strength of conclusions.
Vestibular schwannoma-associated NPH has distinct clinical features compared with idiopathic NPH.
studypartially supportedShunt responsiveness differs between vestibular schwannoma-associated NPH and idiopathic NPH.
studyunclear- PMID
- 42623790
- DOI
- 10.1016/j.jocn.2026.112253.
- Journal
- Journal of Clinical Neuroscience
- Publication type
- research_article
- Evidence level
- 3
- Population
- Patients with vestibular schwannoma-associated normal pressure hydrocephalus and patients with idiopathic NPH
- Intervention
- CSF shunting for normal pressure hydrocephalus
- Comparator
- Idiopathic normal pressure hydrocephalus
Primary outcomes
Clinical features of VS-associated NPH vs idiopathic NPH; Shunt responsiveness in each group