OBJECTIVE AND IMPORTANCE: 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. CLINICAL PRESENTATION: We report a healthy 37-year-old man presenting with SAH after intense physical stress caused by bleeding of a cervical neuroma. INTERVENTION: 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. CONCLUSION: 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.
OBJECTIVE AND IMPORTANCE: 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. CLINICAL PRESENTATION: We report a healthy 37-year-old man presenting with SAH after intense physical stress caused by bleeding of a cervical neuroma. INTERVENTION: 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. CONCLUSION: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.
Authors: Alia Hdeib; C Rory Goodwin; Daniel Sciubba; Ali Bydon; Jean-Paul Wolinsky; Timothy Witham; Ziya L Gokaslan Journal: Int J Spine Surg Date: 2016-12-20
Authors: Gelareh Sadigh; Chad A Holder; Jeffrey M Switchenko; Seena Dehkharghani; Jason W Allen Journal: J Neurosurg Date: 2017-10-13 Impact factor: 5.115