• World Neurosurg · Feb 2020

    Case Reports

    Facial nerve schwannoma complicated by acute hemorrhage post treatment with stereotactic radiosurgery.

    • Mohammad Hassan A Noureldine, R Tushar Jha, Ivo Peto, Patrick J Malafronte, Kyle Allen, and Siviero Agazzi.
    • Department of Neurosurgery, Institute for Brain Protection Sciences, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
    • World Neurosurg. 2020 Feb 1; 134: 128-132.

    BackgroundFacial nerve schwannomas (FNSs) are rare benign tumors that arise from Schwann cells of the facial nerve. FNSs are similar to vestibular schwannomas in many aspects, yet their infiltrative nature into the facial nerve fascicles warrants a more conservative management approach. In the last decade, stereotactic radiosurgery (SRS) has shown promise in stabilizing or shrinking FNSs.Case DescriptionA 71-year-old woman presented with mild facial paresis. Tumor growth after a period of watchful waiting warranted treatment with SRS, which was complicated by an acute posterior fossa hemorrhage and brainstem compression, necessitating microsurgical hematoma evacuation, tumor resection, and facial nerve substitution.ConclusionsSRS has led to better facial nerve function and outcomes and is currently considered a reasonable alternative to microsurgical resection in patients with FNSs. This is the first report to our knowledge of an acute, life-threatening hemorrhage after SRS in a patient with FNS.Copyright © 2019 Elsevier Inc. All rights reserved.

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