Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2006
Intratumoral and brainstem hemorrhage in a patient with vestibular schwannoma and oral anticoagulant therapy.
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Vellin Jean-François, Bozorg Grayeli Alexis, Kalamarides Michel, Fond Cyril, Bouccara Didier, Sterkers Olivier
Аннотация
OBJECTIVE: To report the first case of spontaneous intratumoral and brainstem hemorrhage in a patient with a vestibular schwannoma.
STUDY DESIGN: Case report and review of the literature.
SETTING: University-based, tertiary referral center.
PATIENT: A 73-year-old woman with a vestibular schwannoma, anti-vitamin K overdose, and arterial hypertension experienced a rapid onset of headache, facial palsy, diplopia, and hoarseness.
INTERVENTIONS: The patient was admitted to the intensive care unit and treated with vitamin K and corticoids.
MAIN OUTCOME MEASURES: Clinical and radiologic findings.
RESULTS: At admission, the magnetic resonance imaging and computed tomographic scans showed an intratumoral hemorrhage. The patient entered a coma 24 hours after the onset of the symptoms. At that time, the computed tomographic scan demonstrated a massive intratumoral and brainstem hemorrhage. The patient died 3 days later.
CONCLUSION: Intratumoral, subarachnoid, and brainstem hemorrhages can occur in patients with vestibular schwannoma. Oral anticoagulant therapy is a risk factor for tumor-related hemorrhage.
STUDY DESIGN: Case report and review of the literature.
SETTING: University-based, tertiary referral center.
PATIENT: A 73-year-old woman with a vestibular schwannoma, anti-vitamin K overdose, and arterial hypertension experienced a rapid onset of headache, facial palsy, diplopia, and hoarseness.
INTERVENTIONS: The patient was admitted to the intensive care unit and treated with vitamin K and corticoids.
MAIN OUTCOME MEASURES: Clinical and radiologic findings.
RESULTS: At admission, the magnetic resonance imaging and computed tomographic scans showed an intratumoral hemorrhage. The patient entered a coma 24 hours after the onset of the symptoms. At that time, the computed tomographic scan demonstrated a massive intratumoral and brainstem hemorrhage. The patient died 3 days later.
CONCLUSION: Intratumoral, subarachnoid, and brainstem hemorrhages can occur in patients with vestibular schwannoma. Oral anticoagulant therapy is a risk factor for tumor-related hemorrhage.