Intratumoral Haemorrhage Causing an Unusual Clinical Presentation of a Vestibular Schwannoma

We present a case of an elderly woman with no history of audiological disease with sudden onset of visual and hearing deficits associated with systemic clinical signs. On examination she had impairment of right CNs from V to X. CT and MR imaging demonstrated a cystic vestibular schwannoma with a rar...

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Bibliographic Details
Published in:The neuroradiology journal 2013-02, Vol.26 (1), p.30-34
Main Authors: Gagliardo, C., Martines, F., Bencivinni, F., La Tona, G., Lo Casto, A., Midiri, M.
Format: Article
Language:English
Subjects:
Adult
Female
Functional Laterality
Hearing Loss
Hemorrhage - complications
Humans
Magnetic Resonance Imaging
Neuroma, Acoustic - diagnosis
Neuroma, Acoustic - etiology
Tomography, X-Ray Computed
Young Adult
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Summary:We present a case of an elderly woman with no history of audiological disease with sudden onset of visual and hearing deficits associated with systemic clinical signs. On examination she had impairment of right CNs from V to X. CT and MR imaging demonstrated a cystic vestibular schwannoma with a rare intralesional fluid-fluid level correlated to a recent bleed. We include high quality MR images to show the acute impairment of the cranial nerves next to the tumour after acute bleeding. Our case report includes a voxel-based morphometry (VMB) analysis of the tumour that, as far as we know, has never been done before for such a tumour. VBM analysis was performed to calculate the hypothesized volume changes after the acute bleed which likely resulted in a sudden increase in the overall size of the tumour resulting in atypical clinical signs and symptoms due to the establishment of a mechanical conflict with the adjacent cranial nerves.
ISSN:1971-4009
2385-1996
DOI:10.1177/197140091302600105