Cauda equina schwannoma presenting with subarachnoid and subdural hemorrhage: Its underlying mechanism.

Cauda equina Intratumoral hemorrhage Mechanism Spinal schwannoma Subarachnoid hemorrhage

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2021
Historique:
received: 01 07 2021
accepted: 26 08 2021
entrez: 8 10 2021
pubmed: 9 10 2021
medline: 9 10 2021
Statut: epublish

Résumé

A patient presented with a spinal subarachnoid hemorrhage (SAH) and subdural hematoma (SDH) attributed to a spinal schwannoma at the T12-L1 level. A 67-year-old male acutely presented with severe back pain and L1 paraparesis/sensory loss, with urinary incontinence. CT/MR studies showed a spinal SAH and SDH within a likely T12-L1 schwannoma. At surgery, the hemorrhage within the tumor was continuous through the lower pole of the tumor into the subarachnoid and subdural spaces; tumor was dissected away from the surrounding tissues and totally removed. The postoperative course was uneventful, and the preoperative neurological deficits gradually resolved. Histopathologically, the lesion was a schwannoma with intratumoral hemorrhage. This case demonstrates the rare acute presentation of a T12-L1 schwannoma with an accompanying intratumoral hemorrhage resulting in both a SDH/SAH.

Sections du résumé

BACKGROUND BACKGROUND
A patient presented with a spinal subarachnoid hemorrhage (SAH) and subdural hematoma (SDH) attributed to a spinal schwannoma at the T12-L1 level.
CASE DESCRIPTION METHODS
A 67-year-old male acutely presented with severe back pain and L1 paraparesis/sensory loss, with urinary incontinence. CT/MR studies showed a spinal SAH and SDH within a likely T12-L1 schwannoma. At surgery, the hemorrhage within the tumor was continuous through the lower pole of the tumor into the subarachnoid and subdural spaces; tumor was dissected away from the surrounding tissues and totally removed. The postoperative course was uneventful, and the preoperative neurological deficits gradually resolved. Histopathologically, the lesion was a schwannoma with intratumoral hemorrhage.
CONCLUSION CONCLUSIONS
This case demonstrates the rare acute presentation of a T12-L1 schwannoma with an accompanying intratumoral hemorrhage resulting in both a SDH/SAH.

Identifiants

pubmed: 34621577
doi: 10.25259/SNI_659_2021
pii: 10.25259/SNI_659_2021
pmc: PMC8492430
doi:

Types de publication

Case Reports

Langues

eng

Pagination

462

Informations de copyright

Copyright: © 2021 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Keitaro Shiraishi (K)

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Takahiro Tomita (T)

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Takuya Akai (T)

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Satoshi Kuroda (S)

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Classifications MeSH