In most cases, vestibular schwannomas with papilledema are associated with intracranial hypertension secondary to hydrocephalus (obstructive or communicating). We describe the atypical case of a 39-years-old man who presented with bilateral papilledema revealing a vestibular schwannoma, but without hydrocephalus and with normal intracranial pressure. Ophtalmologic signs were completely resolved after tumor removal. The pathophysiological mechanism generally described to explain bilateral papilledema in such cases is tumor-induced hyperproteinorachia. However, in the absence of hydrocephalus or intracranial hypertension, this case raises the question of the mechanisms involved in the visual impairment related to vestibular schwannoma.

在大多数情况下，伴有视乳头水肿的前庭神经鞘瘤与继发于脑积水（阻塞性或交通性）的颅内高压有关。我们描述了一名 39 岁男性的非典型病例，他出现双侧视乳头水肿，前庭神经鞘瘤，但没有脑积水，颅内压正常。肿瘤切除后，眼科症状完全消失。在这种情况下，通常用于解释双侧视乳头水肿的病理生理机制是肿瘤诱导的高蛋白尿。然而，在没有脑积水或颅内高压的情况下，该病例提出了与前庭神经鞘瘤相关的视力障碍的机制问题。