# Large Sporadic Vestibular Schwannoma Causing Brainstem Compression and Obstructive Hydrocephalus in a Young Adult

## TL;DR

A 21-year-old man had a large sporadic vestibular schwannoma causing brainstem compression and hydrocephalus, emphasizing the need for early imaging in young patients with audiovestibular symptoms.

## Contribution

The case presents a rare instance of a large sporadic vestibular schwannoma in a young adult with a somatic NF2 mutation.

## Key findings

- A 21-year-old man had a large vestibular schwannoma causing brainstem compression and obstructive hydrocephalus.
- Tumor analysis revealed a somatic mutation in NF2, supporting a diagnosis of sporadic vestibular schwannoma.
- The case underscores the importance of early neuroimaging in young patients with progressive audiovestibular symptoms.

## Abstract

Sporadic vestibular schwannomas are typically slow-growing, unilateral cerebellopontine angle benign tumors that occur in middle-aged and older adults and rarely present in individuals younger than 30 years. We describe the case of a 21-year-old man who presented with progressive unilateral hearing loss and tinnitus and was found to have a large vestibular schwannoma causing brainstem compression and obstructive hydrocephalus. Tumor analysis demonstrated a somatic mutation in neurofibromatosis type 2 (NF2), confined to the tumor, supporting a diagnosis of sporadic vestibular schwannoma in the absence of NF2 features. This case highlights the importance of early neuroimaging in patients with persistent or progressive unilateral audiovestibular symptoms.