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KMID : 0942820020010010078
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Journal of Korean Brain Tumor Society
2002 Volume.1 No. 1 p.78 ~ p.80
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Hemorrhagic Presentation of a Vestibular Schwannoma - Case Report -
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Koh Young-Cho
Yoo Heon
Kwon O-Ki
Kim Yong-Man
Ju Mee
Lee Ghi-Jai
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Abstract
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The authors report unusual presentation of a vestibular schwannoma in a 53-year-old man, who presented with sudden onset of severe headache and, vomiting followed by left peripheral type facial palsy two weeks prior to admission. He had been well except for a longstanding left hearing difficulty, which had been considered as an aging process. In addition, he had mitral valve replacement surgery two years prior to admission , for which he had taken anticoagulant(Warfarin 2mg) everyday with regular monitoring of coagulability. Plain CT scan on admission demonstrated a 3×4×3cm sized high density mass at the left cerebellopontine angle with erosion and widening of the left internal auditory meatus. Brain MRI showed a heterogenous signaled mass with high signal on T1WI with little contrast enhancement and low signal on T2WI suggestive of multistaged hematomas within the peripherally enhancing tumor. Under the impression of intratumoral repeated bleeding in a patient with preexisting vestibular schwannoma, left suboccipital craniectomy was undergone to remove a large extraaxial tumor, mixed with large amount of hemorrhages. Postoperative course was uneventful except for persistent left facial palsy and hearing loss. Postoperative anticoagulation was started on the 5th postoperative day.
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KEYWORD
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Vestibular schwannoma, Hemorrhage, Facial Palsy, Anticoagulant
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