OBJECTIVE: To report the first case of spontaneous intratumoral and brainstem hemorrhage in a patient with a vestibular schwannoma. STUDY DESIGN: Case report and review of the literature. SETTING: University-based, tertiary referral center. PATIENT: A 73-year-old woman with a vestibular schwannoma, anti-vitamin K overdose, and arterial hypertension experienced a rapid onset of headache, facial palsy, diplopia, and hoarseness. INTERVENTIONS: The patient was admitted to the intensive care unit and treated with vitamin K and corticoids. MAIN OUTCOME MEASURES: Clinical and radiologic findings. RESULTS: At admission, the magnetic resonance imaging and computed tomographic scans showed an intratumoral hemorrhage. The patient entered a coma 24 hours after the onset of the symptoms. At that time, the computed tomographic scan demonstrated a massive intratumoral and brainstem hemorrhage. The patient died 3 days later. CONCLUSION: Intratumoral, subarachnoid, and brainstem hemorrhages can occur in patients with vestibular schwannoma. Oral anticoagulant therapy is a risk factor for tumor-related hemorrhage.
OBJECTIVE: To report the first case of spontaneous intratumoral and brainstem hemorrhage in a patient with a vestibular schwannoma. STUDY DESIGN: Case report and review of the literature. SETTING: University-based, tertiary referral center. PATIENT: A 73-year-old woman with a vestibular schwannoma, anti-vitamin Koverdose, and arterial hypertension experienced a rapid onset of headache, facial palsy, diplopia, and hoarseness. INTERVENTIONS: The patient was admitted to the intensive care unit and treated with vitamin K and corticoids. MAIN OUTCOME MEASURES: Clinical and radiologic findings. RESULTS: At admission, the magnetic resonance imaging and computed tomographic scans showed an intratumoral hemorrhage. The patient entered a coma 24 hours after the onset of the symptoms. At that time, the computed tomographic scan demonstrated a massive intratumoral and brainstem hemorrhage. The patient died 3 days later. CONCLUSION: Intratumoral, subarachnoid, and brainstem hemorrhages can occur in patients with vestibular schwannoma. Oral anticoagulant therapy is a risk factor for tumor-related hemorrhage.
Authors: Torin P Thielhelm; Aida Nourbakhsh; Scott M Welford; Eric A Mellon; Olena Bracho; Michael E Ivan; Fred Telischi; Cristina Fernandez-Valle; Christine T Dinh Journal: Otolaryngol Head Neck Surg Date: 2022-03-01 Impact factor: 5.591
Authors: Christopher S Hong; Lan Jin; Wyatt B David; Brian Shear; Amy Y Zhao; Yawei Zhang; E Zeynep Erson-Omay; Robert K Fulbright; Anita Huttner; John Kveton; Jennifer Moliterno Journal: J Neurol Surg B Skull Base Date: 2020-03-16