Spinal tumors and subarachnoid hemorrhage: pathogenetic and diagnostic aspects in 5 cases

Abstract

The authors report 5 cases of spinal tumor associated with subarachnoid hemorrhage. Histologically, the tumor was an ependymoma in 2 cases, a neurinoma in 2 cases and a hemangioblastoma in 1 case. The pathogenetic and diagnostic characteristics of these 5 cases are analyzed in the light of other published reports.

Intra-extradural Dumbbell-Shaped Hemangioblastoma Manifesting as Subarachnoid Hemorrhage in the Cauda Equina

“…16) Only 17 cases of hemangioblastoma associated with SAH have been reported 2,3,5,6,8,9,13,16,18,20,21,27,29) (Table 1). The characteristic symptoms of spinal SAH are severe pain along the spinal axis (neck pain and back pain/lumbago), radicular pain, paresis originating at the spinal roots, 16) or myelopathy, as seen in our present patient.…”

Cervical Schwannoma Presenting with Acute Intracranial Subarachnoid Hemorrhage

“…First theory is a mechanical cause 1,5) . Cervoni et al 1) reported that 79% of the 63 tumors associated with SAH were situated in the region of the filum terminale and medullary conus and even thought tumors of this region account for only 20% of spinal tumors and the acute onset of SAH after physical exercise.…”

“…Cervoni et al 1) reported that 79% of the 63 tumors associated with SAH were situated in the region of the filum terminale and medullary conus and even thought tumors of this region account for only 20% of spinal tumors and the acute onset of SAH after physical exercise. Movements of traction along the spine column involving the cervical region may stretch the most superficial portion of the tumor including its vascular connections with the adjacent structures, especially when traction is repeated and prolonged 1) . Such tractional force occur most commonly in areas of high mobility, and this probably explains why the onset of symptoms in 50% of cases is related to exertion 7,9) .…”

“…Spinal cord tumors, either primary or metastatic, may cause subarachnoid hemorrhage (SAH), with ependymoma of the conus medullaris accounting for most of these cases 1,4) . Spinal nerve sheath tumors such as schwannomas rarely cause SAH [1][2][3][4][5][6][7][8][9] , especially in the absence of spinal cord or root symptoms.…”

“…Spinal nerve sheath tumors such as schwannomas rarely cause SAH [1][2][3][4][5][6][7][8][9] , especially in the absence of spinal cord or root symptoms. Parmar et al 9) stated that until 2004 only 20cases of nerve sheath tumors which developed SAH had been reported in the literature.…”