Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
J Clin Neurosci. 2012 Sep;19(9):1305-7. doi: 10.1016/j.jocn.2011.11.028. Epub 2012 Jun 20.
Repeated hemorrhage from a vestibular schwannoma is very rare. We report a 15-year-old male, to our knowledge the fourth known patient with repeated hemorrhage of vestibular schwannoma, who presented with rapidly progressive right-sided hearing loss and tinnitus. MRI showed a mass lesion in the right cerebellopontine angle. T1-weighted and T2-weighted MRI revealed a hyperintense intratumoral area, indicating subacute hemorrhage within the tumor. Nine weeks after the initial onset, the patient again presented with a sudden onset headache, nausea, and ataxia. A CT scan showed recurrence of an intratumoral hemorrhage. A subtotal resection was achieved. A histopathological examination of the resected specimen showed typical features of schwannoma. We review the pertinent literature and discuss the features of repeated hemorrhage from a vestibular schwannoma.
桥小脑角前庭神经鞘瘤反复出血非常罕见。我们报告了 1 例 15 岁男性患者，据我们所知，这是第 4 例已知的桥小脑角前庭神经鞘瘤反复出血的患者，其表现为右侧听力迅速下降和耳鸣。MRI 显示右侧桥小脑角有一肿块病变。T1 加权和 T2 加权 MRI 显示肿瘤内高信号区域，提示肿瘤内亚急性出血。初次发病后 9 周，患者再次突发头痛、恶心和共济失调。CT 扫描显示肿瘤内出血复发。行次全切除术。切除标本的组织病理学检查显示典型的神经鞘瘤特征。我们复习了相关文献，并讨论了桥小脑角前庭神经鞘瘤反复出血的特征。
