Document Detail


Fatal case of tumor-associated hemorrhage in a large vestibular schwannoma.
MedLine Citation:
PMID:  20583739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vestibular schwannomas are benign neoplasms that arise from Schwann cells of the eighth cranial nerve. Most manifest clinically with tinnitus, unilateral sensorineural hearing loss, and dysequilibrium secondary to compression of the vestibulocochlear nerve; major adverse events such as intratumoral hemorrhage causing acute neurologic deterioration are rare. We report the case of a 69-year-old man with a large vestibular schwannoma who required anticoagulation for several medical comorbidities. The patient began having progressively worsening neurologic symptoms, including facial nerve paralysis and dysequilibrium, which confined him to a wheelchair. After presentation, the patient was admitted to the hospital. Several days after alteration of his anticoagulation therapy in preparation for surgery, he developed intracranial hemorrhage. Attempts were made to stabilize the patient, including posterior fossa craniectomy and evacuation of hematoma; however, the intracranial hemorrhage ultimately resulted in a fatal outcome. During this procedure, a biopsy specimen was obtained, showing benign vestibular schwannoma. The literature for intratumoral hemorrhage into vestibular schwannoma and the pathologic findings in our case are reviewed.
Authors:
Charles W Yates; Mitchell Weinberg; Mark J Packer; Abraham Jacob
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  119     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  402-5     Citation Subset:  AIM; IM    
Affiliation:
The Ohio State University, Dept of Otolaryngology-Head and Neck Surgery, OSU Eye and Ear Institute, 915 Olentangy River Rd, Columbus, OH 43212, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use
Comorbidity
Disease Progression
Fatal Outcome
Heart Valve Prosthesis
Humans
Immunohistochemistry
Intracranial Hemorrhages / etiology*
Magnetic Resonance Imaging
Male
Neuroma, Acoustic / complications*,  epidemiology,  metabolism
Retrospective Studies
Warfarin / therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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