Dr. MANISHA NAGPAL

Dr.ABHISHEK AGARWAL

Abstract

A 35-year-old male presented with loss of vision in both eyes (BE) over a period of 6 months. He had nausea, vomiting, headache, hearing decreased in the left ear, abnormal gait. On examination, perception of light was negative in BE, upgaze palsy, nystagmus, bilateral lid retraction, and light-near dissociation. Intraocular pressure was 20 mmHg BE. The fundus examination revealed severe bilateral papilledema and disc hemorrhages. MRI brain revealed a large extra-axial expansile mass lesion (39*47*47mm) at the left cerebellopontine angle which occupied the left internal auditory channel causing deformation of the middle cerebellar peduncle, compression of the brainstem and left cerebellar hemisphere with effacement of the fourth ventricle with dilatation of third and bilateral lateral ventricles suggestive of vestibular schwannoma. This case report represents dorsal midbrain syndrome as a result of brain stem compression due to vestibular schwannoma with blindness due to papilledema.