Sudden Neurological Deterioration Due to Repeated Intratumoral Hemorrhage in a Patient with a Vestibular Schwannoma

Vestibular schwannomas (VS) are the most common tumors involving the cerebellopontine angle (CPA) and the internal auditory canal (IAC). These tumors are usually slow growing and commonly present with cranial nerve dysfunction such as hearing loss. While intratumoral hemorrhage (ITH) is fairly uncommon, it may lead to sudden neurological worsening. Repeated ITH is extremely rare with only four cases previously reported.

We report the case of a 30-year-old woman with a right-sided CPA tumor who presented with vertigo and ataxia due to ITH. Her symptoms initially improved; however, 3 weeks later, she had acute onset of facial palsy and imaging confirmed rebleeding. Surgical pathology confirmed schwannoma and the patient had stable neurological deficits postoperatively. A literature review was performed using the PubMed and EMBASE databases yielded four previous reports. A summary of these cases is presented and the features of each case are discussed.

Publication History

Publication Date:
02 February 2018 (online)