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British journal of neurosurgery · 2020

Very small vestibular schwannoma as the source of fatal subarachnoid hemorrhage: a case report.

Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Kuroiwa Masafumi, Murata Takahiro, Hirayama Shuichi, Hokama Masanobu, Miyashita Toshihiko

Аннотация

BACKGROUND: Subarachnoid hemorrhage (SAH) is commonly caused by an aneurysm, trauma, other vascular diseases, and infrequently by a metastatic tumor or glioma. SAH due to a benign intracranial tumor, such as a vestibular schwannoma (VS), is rare. We report a case in which a very small (1 mm) VS caused fatal SAH.

CASE PRESENTATION: A 75-year-old woman presented with a sudden severe headache. Computed tomography showed SAH at the right of the cerebellopontine angle. On post-onset day (POD) 27, MRI revealed a 1-mm mass on the cerebellopontine angle's right side. She was discharged with House-Brackmann grade 4 right-side facial weakness and hearing disturbance. She re-presented on POD 45 with headache and loss of consciousness. Computed tomography revealed massive SAH and intracerebellar hemorrhage. She died 4 days later. Histopathological evidence indicated a highly vascular vestibular schwannoma.

CONCLUSIONS: Vestibular schwannoma should therefore be considered a source of SAH, particularly in patients with facial weakness and/or hearing disturbance.

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