Papilledema and Spinal Cord Tumor

Rennes University Hospital 35033 Rennes CEDEX, France 49-year-old man presented with a three-week history of pro gressive visual loss and headaches. Funduscopic examination revealed bilateral papilledema. Computed tomographic examination of the cerebrum showed a moderate-sized, communicating hydrocephalus. Analysis of cerebrospinal fluid from a lumbar puncture showed a high protein concentration (1632 mg per deciliter). On further questioning, the patient reported a one-year history of intermittent low back pain. Magnetic resonance imaging of the spine showed a tumor of the conus medullaris; a benign ependymoma was completely removed. Postoperatively, the patient’s headaches cleared spontaneously, and the findings on funduscopy and the visual acuity returned to normal within four weeks.