title: Hypoglossal neurinoma presenting with intratumoral hemorrhage.
abstract: Focal or microscopic hemorrhage in a neurinoma is common, but tumor origin from the hypoglossal nerve and extensive symptomatic intratumoral hemorrhage are both rare. A 59-year-old male presented with severe neck pain, nausea and vomiting of 1-day duration, accompanied by right hypoglossal nerve palsy. Neuroimaging disclosed a tumor located in the right cerebellomedullary fissure and containing a hematoma. The right hypoglossal canal was slightly dilated. The intracranial tumor was resected via a suboccipital approach. Histological examination demonstrated spindle-shaped tumor cells with nuclear palisading and also relative hypervascularity with hyaline degeneration of the vessels. Extensive hemorrhage was present, as was necrosis. Thickening and hyalinization of arterial walls, a common occurrence in neurinomas, may have contributed to symptomatic intratumoral hemorrhage.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sato
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshimoto
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D007002:Hypoglossal Nerve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D020437:Hypoglossal Nerve Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed