Kim S H, Youm J Y, Song S H, Kim Y, Song K S
Department of Neurosurgery, Chungnam National University Hospital, Taejon, South Korea.
Clin Neurol Neurosurg. 1998 Mar;100(1):68-74. doi: 10.1016/s0303-8467(98)00002-x.
A symptomatic hemorrhage from a vestibular schwannoma is extremely rare, despite its relatively high incidence in the cerebellopontine angle. Much more unusual are repeated intratumoral hemorrhages. The authors report on such a rare case of repeated intratumoral hemorrhage from a vestibular schwannoma, presenting with sudden exacerbation of headache, nausea and vomiting. This second hemorrhage was confirmed by CT scan on the day of the onset of symptomatic exacerbation, which was 9 days after the initial CT scan, showing an enlarged amount of blood within the tumor. The MRI scan confirmed this CT finding. After removal, the tumor proved to be a typical vestibular schwannoma of mixed Antoni types A and B. Thin-dilated vessels with hemorrhage and hemosiderin-laden macrophages were observed. The patient's postoperative course was uneventful. A total of 28 reported cases of a single intratumoral hemorrhage in vestibular schwannomas, and one reported case of repeated hemorrhage are reviewed.
尽管前庭神经鞘瘤在桥小脑角的发病率相对较高，但其出现症状性出血极为罕见。更为不寻常的是肿瘤内反复出血。作者报告了这样一例罕见的前庭神经鞘瘤反复肿瘤内出血病例，表现为头痛、恶心和呕吐突然加重。第二次出血在症状加重当天经CT扫描证实，此时距离初次CT扫描已过去9天，显示肿瘤内血量增多。MRI扫描证实了这一CT检查结果。切除后，肿瘤被证实为典型的A、B型混合的前庭神经鞘瘤。观察到有扩张的细血管伴出血以及含铁血黄素巨噬细胞。患者术后恢复顺利。本文回顾了总共28例已报道的前庭神经鞘瘤单发肿瘤内出血病例以及1例已报道的反复出血病例。
