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05-AUGUST-2009 ZUHAYER RASHEED ABDEL-MAJEED 67
YEARS NORMAL PRESSURE HYDROCEPHALUS WITH ACOUSTIC SCHWANNOMA LEFT SIDE.
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The patient came to the
clinic 02-August-2009 complaining of tinnitus
left ear with loss of hearing left side. The
patient also got memory disturbances for 2
months and inability to walk or set with signs
of dementia. He could walk with the help of two
persons with shuffling gait and he has aphonia.
There is mild left sided paresis. There is no
nystagmus, nor cerebellar signs. The patient is
MRI of the brain performed
23-July-2009 showing medium sized
acoustic schwannoma with left
intracannalicular extension not causing shift of
the brain stem nor the aqueduct of Sylvius.
The patient was treated
initially for Parkinson
disease, but he
deteriorated, for what
The patient was
considered to have
(NPH) for what VPS
shunt adult size was
inserted to the right
side. During that biopsy
was performed with the
CSF sent for
investigations to rule
Routine closure of the wounds
and smooth postoperative recovery.
This case is interesting in
the prospect, that several pathologies having
place at the same time. The dilatation of the
left internal meatus, indicate that the
schwannoma having place for several years and
since the patient has at the present time having
memory disturbances and dementia, it hard to
tell when he got hearing loss which could be for
The volume of the tumor
cannot explain the wide-spread involvement of
the brain and the brain stem dysfunctions.
Even normal pressure
hydrocephalus cannot explain the aphonia, but it
is more convincing to explain most of his
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .