Marques Renata, Nogueira João, Cambango Maura, Coimbra Frederica, Saraiva João, Duarte Nubélio, Carneiro Ângelo, Afonso Filipe Miguel
Neurosurgery Department, Hospital de Braga, Braga, PRT.
Neuroradiology Department, Hospital de Braga, Braga, PRT.
Cureus. 2022 Dec 19;14(12):e32716. doi: 10.7759/cureus.32716. eCollection 2022 Dec.
Subarachnoid hemorrhage (SAH) is a rare manifestation of brain tumors, being even rarer in vestibular schwannomas. We report the second case of a posterior circulation aneurysm close to the tumor capsule, responsible for SAH as an initial manifestation of a vestibular schwannoma. A 67-year-old female was admitted to the Emergency Department with sudden onset of nausea and headache. A diagnosis of a SAH and a tumor of the right cerebellopontine angle was made. An angiography showed an aneurysm in the dependency of the right anterior inferior cerebellar artery (AICA), juxtaposed to the tumor capsule. The patient underwent surgery, the tumor was removed, and the aneurysm was treated. This case highlights that SAH in patients with vestibular schwannoma may originate from a contact aneurysm. Although exceedingly rare, surgeons should consider this scenario in vestibular schwannoma presenting with SAH, and angiography is important for its diagnosis.
蛛网膜下腔出血（SAH）是脑肿瘤的一种罕见表现，在前庭神经鞘瘤中更为罕见。我们报告第二例靠近肿瘤包膜的后循环动脉瘤，该动脉瘤导致SAH作为前庭神经鞘瘤的初始表现。一名67岁女性因突然出现恶心和头痛入住急诊科。诊断为SAH和右侧小脑脑桥角肿瘤。血管造影显示右侧小脑前下动脉（AICA）供血区有一个动脉瘤，与肿瘤包膜相邻。患者接受了手术，切除了肿瘤并治疗了动脉瘤。该病例强调，前庭神经鞘瘤患者的SAH可能源于接触性动脉瘤。尽管极为罕见，但对于出现SAH的前庭神经鞘瘤患者，外科医生应考虑这种情况，血管造影对其诊断很重要。
