Entezami Pouya, Riccio Alexander, Kenning Tyler J
Department of Neurosurgery, Albany Medical College, Albany, New York, USA.
Department of Neurosurgery, Albany Medical College, Albany, New York, USA.
World Neurosurg. 2018 Sep;117:246-248. doi: 10.1016/j.wneu.2018.06.100. Epub 2018 Jun 21.
Intracranial hemorrhage stemming from a benign intracranial lesion is much less commonly seen than from malignant tumors such as gliomas or metastases. Cerebellopontine angle (CPA) lesions rarely present with hemorrhage.
We describe the case of a 49-year-old male with a recurrent right CPA meningioma arising from the petrous bone that was previously treated with a subtotal resection and postsurgical radiosurgery, presenting with acute left-sided hemiparesis secondary to intratumoral hemorrhage. Although surgical evacuation and decompression were recommended, the patient declined operative intervention and was managed medically.
Meningiomas can cause subarachnoid, intraparenchymal, and rarely intratumoral hemorrhage. Symptomatic hemorrhage can worsen the prognosis, with increased morbidity and mortality. Several etiologies have been proposed for this phenomenon including rupture of aberrant vasculature, intratumoral necrosis, and tearing of stretched bridging veins. Only 2 prior cases of CPA meningioma have been reported in the literature. Recognition of CPA meningioma hemorrhage as a clinical entity can help in future diagnoses and management.
源于良性颅内病变的颅内出血比源于恶性肿瘤（如胶质瘤或转移瘤）的颅内出血少见得多。桥小脑角（CPA）病变很少出现出血。
我们描述了一名49岁男性病例，其右侧CPA脑膜瘤复发，起源于岩骨，此前接受了次全切除和术后放射外科治疗，现因肿瘤内出血继发急性左侧偏瘫。尽管建议进行手术清除和减压，但患者拒绝手术干预，接受了保守治疗。
脑膜瘤可导致蛛网膜下腔、脑实质内出血，肿瘤内出血罕见。有症状的出血会使预后恶化，发病率和死亡率增加。针对这一现象提出了几种病因，包括异常血管破裂、肿瘤内坏死以及拉伸的桥静脉撕裂。文献中仅报道过2例CPA脑膜瘤病例。认识到CPA脑膜瘤出血作为一种临床实体有助于未来的诊断和治疗。
