title: A 30 year old man with an acute presentation of a cerebellopontine angle lesion.
abstract: Schwannomas are slow-growing tumors with symptoms manifesting progressively. We report the case of a patient who manifested a sudden loss of consciousness as clinical presentation of an intracranial schwannoma with no acute hemorrhage or hydrocephalus. A 30-year-old male presented comatose and posturing. Cerebral CT revealed an extra-axial lesion with a heterogeneous enhancement and a cystic component located on the right cerebellopontine angle (CPA), displacing the brain stem. No acute hemorrhage or hydrocephalus was documented. Through a retrosigmoid suboccipital craniotomy, an extended subtotal tumor resection was performed. The patient experienced no functional hearing impairment and resumed his daily-life activities 3 months after surgery. Histopathological examination was compatible with a benign schwannoma. An exuberant lymphoplasmacytic infiltrate was found in many areas, signing the presence of an unusual inflammatory reaction with adjacent important intratumoral edema. We propose that the exuberant inflammatory infiltrate and the associated intratumoral edema acted as determining elements in the increase of mass effect and sudden clinical deterioration.
authors: Division of Neurosurgery, Department of Surgery, Centre Hospitalier de l'Université de Montréal-Hôpital Notre-Dame, Montreal, QC, Canada.
authors: Nancy
authors: N
authors: McLaughlin
authors: France
authors: F
authors: Berthelet
authors: Michel W
authors: MW
authors: Bojanowski
mesh_terms: D000328:Adult; D002530:Cerebellopontine Angle / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D003399:Craniotomy; D006801:Humans; D008297:Male; D009464:Neuroma, Acoustic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011859:Radiography; D016896:Treatment Outcome