Cauda equina schwannoma presenting with subarachnoid and subdural hemorrhage: Its underlying mechanism

Keitaro Shiraishi; Takahiro Tomita; Takuya Akai; Satoshi Kuroda

doi:10.25259/SNI_659_2021

Cauda equina schwannoma presenting with subarachnoid and subdural hemorrhage: Its underlying mechanism

Surg Neurol Int. 2021 Sep 13:12:462. doi: 10.25259/SNI_659_2021. eCollection 2021.

Authors

Keitaro Shiraishi¹, Takahiro Tomita¹, Takuya Akai¹, Satoshi Kuroda¹

Affiliation

¹ Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.

Abstract

Background: A patient presented with a spinal subarachnoid hemorrhage (SAH) and subdural hematoma (SDH) attributed to a spinal schwannoma at the T12-L1 level.

Case description: A 67-year-old male acutely presented with severe back pain and L1 paraparesis/sensory loss, with urinary incontinence. CT/MR studies showed a spinal SAH and SDH within a likely T12-L1 schwannoma. At surgery, the hemorrhage within the tumor was continuous through the lower pole of the tumor into the subarachnoid and subdural spaces; tumor was dissected away from the surrounding tissues and totally removed. The postoperative course was uneventful, and the preoperative neurological deficits gradually resolved. Histopathologically, the lesion was a schwannoma with intratumoral hemorrhage.

Conclusion: This case demonstrates the rare acute presentation of a T12-L1 schwannoma with an accompanying intratumoral hemorrhage resulting in both a SDH/SAH.

Keywords: Cauda equina; Intratumoral hemorrhage; Mechanism; Spinal schwannoma; Subarachnoid hemorrhage.

Publication types

Case Reports