Abstract

Generally intracranial tumors causing bilateral papilledema present with hydrocephalus. The lack of hydrocephalus despite extensive and aggressive tumor spread make this case unique to report. We report a case of 11-year-old girl who presented with left sided headache with visual deterioration and bilateral fundoscopy on fundus examination. Magnetic resonance imaging (MRI) revealed an extra axial intracranial mass in the middle cranial fossa compressing the ventricles and the orbit. Even though there was ventricular compression and midline shift, the patient had bilateral papilledema without hydrocephalus. It is thought that the papilledema developed by some other mechanism and is not connected with hydrocephalus. Raised intracranial pressure in children can be due to Idiopathic intracranial hypertension (pseudotumor cerebri) or due to a secondary cause like meningitis, structural defects, tumors as seen in this case. Therefore, fundus examination is important in pediatric patients presenting with headache as papilledema may be the rst sign of an intracranial tumor with or without hydrocephalus.

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