Cauda equina schwannoma presenting with intratumoral hemorrhage and intracranial subarachnoid hemorrhage

Case report

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The authors report the case of a spinal intradural schwannoma presenting with intracranial subarachnoid hemorrhage (SAH). Cerebral angiography did not show any intracranial lesion; however, MRI revealed two separate tumors in the lower segment of the spinal cord. The proximal lesion arising from the conus medullaris was well circumscribed and homogeneously enhanced, whereas the tumor in the cauda equina revealed hemorrhagic signals on MRI. This case also illustrates an unusual presentation of intracranial SAH simultaneously with intratumoral hemorrhage in a spinal cord schwannoma. The absence of hemorrhagic changes in the lesion arising proximal to the cauda equina region supports the mechanical theory proposed for the pathogenesis of hemorrhagic complications in spinal cord tumors.

Abbreviation used in this paper:SAH = subarachnoid hemorrhage.
Article Information

Contributor Notes

Address correspondence to: Anil Nanda, M.D., M.P.H., Department of Neurosurgery, Louisiana State Health Sciences Center–Shreveport, P.O. Box 33932, 1501 Kings Hwy., Shreveport, LA 71130-3932. email: ananda@lsuhsc.edu.Please include this information when citing this paper: published online June 13, 2014; DOI: 10.3171/2014.5.SPINE131014.
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