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Spinal schwannoma causes acute subarachnoid haemorrhage: A case report and literature review - 12/01/21

Doi : 10.1016/j.neuchi.2020.12.002 
Peng Chen, Yao Guo, Rui Huang, Juexian Xiao , Zujue Cheng
 Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang 330000, Jiangxi, People's Republic of China 

Corresponding author. Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China, Mobile no: +86-13870876167.Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang 330006, Jiangxi, People's Republic of China, Mobile no: +86-13870876167⁎⁎Corresponding author. Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China, Mobile no: +86-15279109079.Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China, Mobile no: +86-15279109079
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Tuesday 12 January 2021

Abstract

Background

Spinal schwannomas that arise from spinal nerve root sheaths are the most common intradural extramedullary spinal tumours and are often accompanied by nerve roots or spinal cord irritation symptoms. The phenomenon of spinal schwannoma causing subarachnoid haemorrhage (SAH) is rare, with ependymoma of the conus medullaris accounting for most cases.

Case report

A 45-year-old man was admitted to our hospital due to progressive lower limb weakness and sudden back pain after hard physical work. The patient had not been able to walk for 2hours upon admission. An emergency magnetic resonance imaging (MRI) scan showed that the spinal cord at the C6-T4 level was severely compressed by a subdural mass. During the emergency operation, exploration of the dura and arachnoid mater revealed a fresh blood clot covering a tumour located on the ventral side of the spinal cord. The size of the tumour was approximately 3×2×1cm without adhesion to the surrounding tissue, but the drainage vein was ruptured. Postoperative pathology showed that the tumour was a schwannoma with areas of fresh haemorrhage and focal necrosis.

Conclusions

Spinal schwannomas presenting with SAH are rare events. In our opinion, spinal pathology with rapid progression of neurological symptoms requires early diagnosis and emergency management. Complete excision of haemorrhagic tumours is the goal of treatment to prevent recurrence, which can effectively avoid irreversible damage to the spinal cord resulting from spinal cord compression.

Le texte complet de cet article est disponible en PDF.

Keywords : Schwannoma, Subarachnoid haemorrhage, Pain, Paralysis, Thoracic



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