Corriero G, Iacopino D G, Valentini S, Lanza P L
Department of Neurosurgery, Annunziata Hospital, Cosenza, Italy.
Neurosurgery. 1996 Nov;39(5):1046-9. doi: 10.1097/00006123-199611000-00036.
The association of subarachnoid hemorrhage (SAH) with spinal lesions is well known, but hemorrhage from a cervical schwannoma is exceedingly rare. The histopathology and the mechanism of bleeding are discussed.
We report a healthy 37-year-old man presenting with SAH after intense physical stress caused by bleeding of a cervical neuroma.
A C6-T1 laminectomy disclosed an ovoid lesion, 4 cm in diameter; extremely dilated veins originated from the tumor. Removal of the spinal lesion resulted in immediate decongestion of the related venous network. The histopathological examination confirmed that the lesion was a telangiectatic schwannoma. The mechanism of bleeding of the intraforaminal cervical schwannoma is discussed.
Telangiectatic neuromas may be a cause of occult SAH. The importance of magnetic resonance imaging of the cervical spine is emphasized to explain SAH with negative findings on four-vessel angiography in patients whose SAH may have a surgically correctable cause distant from the intracranial compartment.
