Intratumoral Hemorrhage of the Cervical Spinal Schwannoma Presenting: Acute Quadriparesis

Jung, Gyu Seo; Lee, Young Min; Kim, Young Zoon; Kim, Joon Soo

doi:10.14791/btrt.2019.7.e34

Cited by 5 publications

(10 citation statements)

References 15 publications

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“…8,32) Spinal traumas may aggravate these situations while an adjunctive risk-factor may be an anticoagulant/ antiplatelet therapy. 27) Considering the histological features of our specimen (intratumoral dilated blood vessels showing tortuous course, with fragile, hyalinized walls, and focal ischemic damage), the clinical history of the patient (no history of trauma), and the intraoperative appearance of the lesion (attached to an ectatic but intact vessel perforating the dura mater), we hypothesize that extensive bleeding might be associated with spontaneous rupture of intratumoral blood vessels. Bleeding started within the lesion at first and then involved the subdural space.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic Schwannoma of the Cauda Equina: Case Report and Review of the Literature

Fabbri

Friso

Chiarucci

et al. 2021

NMC Case Report Journal

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Spinal intradural hemorrhage is a rare event; the most common causes of spinal bleeding are traumas, medical therapy with anticoagulants and thrombolytics, vascular malformations, and congenital defects of coagulation. Rarely, spinal cord tumors may cause hemorrhage. Herein, we report the case of a patient with acute and quickly worsening lumbar pain: the neurological examination revealed a flaccid paraplegia caused by an intradural lesion extending on the right side of the spinal cord from T1 to L2 vertebral level. Pathological examination revealed an hemorrhagic schwannoma. Acute spinal subdural hemorrhage caused by spinal schwannomas is a very rare occurrence (29 cases only have been previously reported). Review of the literature with clinico-diagnostic features is presented, surgical treatment is explained, and pathological findings with possible etiopathogenesis of hemorrhage are described.

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Section: Discussionmentioning

confidence: 99%

Hemorrhagic Schwannoma of the Cauda Equina: Case Report and Review of the Literature

Fabbri

Friso

Chiarucci

et al. 2021

NMC Case Report Journal

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“…Table I summarizes the reported cases of spinal schwannomas with intratumoral hemorrhage (traumatic or spontaneous), presented with acute neurologic deficit (3,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). There is a limited number of cases with rapidly progressive neurological deficits due to acute cord compression, caused by tumor bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Sudden cord compression caused by tumor bleeding is similar to spinal shock (20). Nine traumatic cases with intratumoral bleeding have been reported so far (8,13,16,(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

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Acute paraplegia due to thoracolumbar schwannoma following trauma: A case report and literature review

et al. 2021

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Spinal schwannomas account for one third of primary spinal neoplasms. Clinical presentation is related to the tumor location. An atypical case of acute paraplegia following a fall, on the ground of a thoracolumbar schwannoma, without intratumoral hemorrhage, in a previously asymptomatic patient is reported. A 58-year-old male patient presented with acute paraplegia, and urinary and bowel incontinence, following a fall. The patient had no previous history of back and/or leg pain or neurological symptoms. Magnetic resonance imaging revealed a subdural mass, as well as a fracture of the right T12-L1 facet joint and the right transverse process. The patient underwent emergency T11-L1 wide laminectomy, exploration of the subdural space and T10-L2 posterolateral transpedicular stabilization and fusion. An intradural, extramedullary mass, causing severe cord compression, was found and excised. Pathology revealed schwannoma, without intratumoral hemorrhage. The patient recovered completely 6 months postoperatively. To the best of our knowledge, this is the first report of spinal intradural schwannoma causing sudden paraplegia in a previously asymptomatic patient in the setting of trauma, without intratumoral hemorrhage. Emergency canal decompression and complete excision of the tumor represent the optimal management of such cases.

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“…[ 7 , 10 ] Patients with acute intratumoral hemorrhages into cervical schwannomas may present with the rapid onset of pain, radiculopathy, and/or myelopathy warranting urgent/emergent resection and stabilization. [ 2 - 4 , 6 , 9 ]…”

Section: Introductionmentioning

confidence: 99%

Cervical schwannoma with acute worsening and intratumoral hemorrhage

Mahajan

Patel

Hdeib

2021

Surgical Neurology International

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Background: Primary spinal tumors are rare and include schwannomas. In the cervical region, these lesions can cause pain, radiculopathy, and/or myelopathy. Case Description: A 53-year-old male presented with 9 months of chronic neck pain and left upper extremity radiculopathy/myelopathy. The MRI revealed an intradural extramedullary C6-C7 mass left-sided mass with foraminal extension. Following a C5-C7 laminectomy with C5-T2 instrumented fusion, the diagnosis of schwannoma with evidence of recent hemorrhage was confirmed by biopsy. Three weeks postoperatively, the patient was pain free, no longer taking opioids, and neurologically intact. Although the MR 6 months later showed no tumor, the MRI 15 months later documented a recurrent enhancing C6-C7 lesion. The patient elected to be treated with external beam radiotherapy and remained asymptomatic. Conclusion: A 53-year-old underwent resection of a cervical C6-C7 schwannoma with intratumoral hemorrhage. Fifteen months following C5-C7 laminectomy with C5-T2 fusion, the tumor recurred and required external beam radiation therapy.

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Intratumoral Hemorrhage of the Cervical Spinal Schwannoma Presenting: Acute Quadriparesis

Cited by 5 publications

References 15 publications

Hemorrhagic Schwannoma of the Cauda Equina: Case Report and Review of the Literature

Hemorrhagic Schwannoma of the Cauda Equina: Case Report and Review of the Literature

Acute paraplegia due to thoracolumbar schwannoma following trauma: A case report and literature review

Cervical schwannoma with acute worsening and intratumoral hemorrhage

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