Shen Zhe, Chen Haoyang, Wang Haosheng, Wang Yaoqi, Li Tao
Department of Neurosurgery, The First Affiliated Hospital of Henan University of Science and Technology, 24 JingHua Road, Luoyang, 471000, Henan, China.
J Med Case Rep. 2024 Dec 21;18(1):633. doi: 10.1186/s13256-024-04968-4.
Spinal schwannomas presenting with an intraspinal hematoma or subarachnoid hemorrhage are extremely rare, and patients often have severe spinal cord compression symptoms. However, the mechanism underlying the bleeding remains unclear.
We present the case of a 53-year-old Chinese female diagnosed with a T12 schwannoma accompanied by an intratumoral hematoma. The patient suddenly experienced unbearable pain in the lower limbs. An emergency operation was necessary, and during surgery, we resected a tumor and evacuated a hematoma. We found a spinal nerve root fracture, intratumoral congestion, tumor capsule rupture, and bleeding. Pathological analysis indicated a schwannoma.
Injury to the nerve roots and vessels during motion, nerve root torsion, twisting, venous obstruction, tumor congestion, swelling, and capsule rupture are important processes in spinal schwannoma hemorrhage. Early diagnosis and proactive surgery are key points for treatment.
伴有脊髓内血肿或蛛网膜下腔出血的脊髓神经鞘瘤极为罕见，患者常出现严重的脊髓压迫症状。然而，出血的潜在机制尚不清楚。
我们报告一例53岁中国女性，诊断为T12神经鞘瘤并伴有瘤内血肿。患者突然出现下肢难以忍受的疼痛。急诊手术是必要的，手术中我们切除了肿瘤并清除了血肿。我们发现脊神经根断裂、瘤内充血、肿瘤包膜破裂和出血。病理分析显示为神经鞘瘤。
运动过程中神经根和血管的损伤、神经根扭转、扭曲、静脉阻塞、肿瘤充血、肿胀和包膜破裂是脊髓神经鞘瘤出血的重要过程。早期诊断和积极手术是治疗的关键。
