• J Clin Neurosci · Mar 2019

    Review Case Reports

    Sudden neurological deterioration due to repeated intratumoral hemorrhage in a patient with a vestibular schwannoma.

    • Mostafa Fatehi Hassanabad and Ryojo Akagami.
    • Division of Neurosurgery, Vancouver General Hospital, 899, 12th Avenue West, Vancouver V5Z1M9, Canada. Electronic address: m.fatehi@utoronto.ca.
    • J Clin Neurosci. 2019 Mar 1; 61: 304-307.

    AbstractVestibular schwannomas (VS) are the most common tumors involving the cerebellopontine angle (CPA) and the internal auditory canal (IAC). These tumors are usually slow-growing and commonly present with cranial nerve dysfunction such as hearing loss. Repeated intratumoral hemorrhage (ITH) is extremely rare with only four cases previously reported. We report the case of a 30 year old female with a right sided CP angle tumor who presented with vertigo and ataxia due to ITH. Her symptoms initially improved; however, three weeks later, she had acute onset of facial palsy and imaging confirmed rebleeding. Surgical pathology reported typical features of schwannoma. A literature review performed using the PubMed and EMBASE databases yielded four previous reports. A summary of these cases is presented and the features of ITH are discussed. Patients affected by repeated ITH present with sudden headache and ataxia. Rapid worsening of cranial nerve dysfunction such as hearing loss or facial nerve palsy is suggestive of ITH.Copyright © 2018 Elsevier Ltd. All rights reserved.

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