Ciappetta Pasqualino, D'Urso Pietro I, Colamaria Antonio
Department of Neuroscience, Section of Neurosurgery, University of Bari Medical School, Bari, Italy.
Neurosurgery. 2008 May;62(5):E1166; discussion E1166. doi: 10.1227/01.neu.0000325881.21118.a6.
Schwannomas located at the craniovertebral junction are rare. Intratumoral microscopic bleeding may be a common finding, but an acute hemorrhagic presentation is an unusual occurrence.
We report the case of a 44-year-old woman with acute onset of a hemorrhagic schwannoma of the C2 nerve root.
An emergency left far-lateral approach and a hemilaminectomy extending from C2 to C5 was performed. The tumor appeared as a dark-reddish subarachnoid mass. Tumor dissection and total removal were achieved by fragmentation and aspiration with an ultrasonic aspirator. A histological examination revealed a schwannoma with a hemorrhagic component.
Our case highlights the importance of early and proper management of the pathologies of the craniovertebral junction with acute onset. The suspicion of an intratumoral hemorrhagic event must be considered when an acute onset of symptoms is present, even in patients without coagulopathies.
位于颅颈交界区的施万细胞瘤较为罕见。瘤内微小出血可能是常见表现，但急性出血性表现并不常见。
我们报告一例44岁女性，其C2神经根急性出血性施万细胞瘤发病。
采用急诊左侧远外侧入路并进行从C2至C5的半椎板切除术。肿瘤表现为暗红色蛛网膜下肿物。通过超声吸引器破碎和抽吸实现肿瘤分离及全切。组织学检查显示为伴有出血成分的施万细胞瘤。
我们的病例突出了对急性发病的颅颈交界区病变进行早期恰当处理的重要性。即使在没有凝血功能障碍的患者中，当出现症状急性发作时，也必须考虑瘤内出血事件的可能性。
