Rao Priya, Thibodeau Ryan, Jafroodifar Abtin, Mangla Rajiv
Department of Radiology, SUNY Upstate Medical University, Syracuse, New York, USA.
Radiol Case Rep. 2021 Aug 1;16(10):2841-2846. doi: 10.1016/j.radcr.2021.06.082. eCollection 2021 Oct.
Vestibular schwannomas, also known as acoustic neuromas, are benign tumors that arise from Schwann cells near the transition from glial cells to Schwann cells. While most vestibular schwannomas are hypovascular tumors, a small percentage constitute the hemorrhagic and/or hypervascular vestibular schwannomas (HVS) subtype. We describe a case of a 36-year-old female who presented with nausea, vomiting, and an acute decrease in vision in her right eye. Computed tomography of the head demonstrated a hemorrhagic lesion in the right hemisphere with evidence of ventricular effacement. Follow-up magnetic resonance imaging revealed a mass in the right cerebellopontine angle that was hypointense on T1-weighted imaging and mild hyperintense heterogeneous signal on T2-weighted imaging, suggestive of a hemorrhagic vestibular schwannoma. It is important for radiologists to recognize the unique clinical and radiological features of HVS in the initial diagnostic assessment of cerebellopontine angle tumors and to distinguish it from common (hypovascular) vestibular schwannomas and other related pathologies. A preoperative diagnosis of HVS allows clinicians to become familiar with the unique characteristics of the tumor and to devise a feasible operative strategy prior to surgical resection.
前庭神经鞘瘤，也被称为听神经瘤，是起源于神经胶质细胞向施万细胞转变部位附近的施万细胞的良性肿瘤。虽然大多数前庭神经鞘瘤是低血供肿瘤，但一小部分属于出血性和/或高血供前庭神经鞘瘤（HVS）亚型。我们描述了一例36岁女性病例，该患者出现恶心、呕吐以及右眼视力急性下降。头部计算机断层扫描显示右半球有一个出血性病变，伴有脑室受压的迹象。后续的磁共振成像显示右小脑脑桥角有一个肿块，在T1加权成像上呈低信号，在T2加权成像上呈轻度高信号且信号不均匀，提示为出血性前庭神经鞘瘤。对于放射科医生来说，在小脑脑桥角肿瘤的初始诊断评估中识别HVS的独特临床和放射学特征，并将其与常见的（低血供）前庭神经鞘瘤及其他相关病变区分开来非常重要。术前诊断为HVS可使临床医生熟悉肿瘤的独特特征，并在手术切除前制定可行的手术策略。
