title: Clinical and radiological aspects of cerebellopontine neurinoma presenting with recurrent spontaneous bleedings.
abstract: BACKGROUND
  Neurinomas are benign, usually encapsulated, tumors growing in peripheral nerve sheath with a high incidence in the cerebellopontine angle.
  
  
  METHODS
  We report a case of vestibular neurinoma (VN) with a "biphasic" pattern of intratumoral hemorrhage presenting with cephalalgia along with progressive ipsilateral mild impairment of both VII and VIII cranial nerves. A thorough preoperative magnetic resonance imaging study better characterized the patchy pattern of the round shaped lesion, resulting in three different intensity signals, due to the peculiar characteristics of the tumoral mass and the recurrent bleedings, respectively. Postoperatively, histological examination confirmed the diagnosis of neurinoma.
  
  
  CONCLUSIONS
  Hemorrhagic VN are rare tumors; from the first case described in 1974 only 43 more have been reported in the literature so far. Noteworthy, "biphasic" bleedings are even rarer. From an accurate review of the literature we collected and thus emphasized the radiological and clinical features of this rare entity. Eventually, we suggest that the early surgical removal of clots and tumor is essential to provide the best chance of neurological improvement.
authors.affiliation: Department of Neurosurgery, Policlinic University of Messina, 98126 Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Maimone
authors.forename: Maimone
authors.initials: M
authors.lastname: Giuseppe
authors.forename: Mario
authors.initials: M
authors.lastname: Ganau
authors.forename: Ganau
authors.initials: G
authors.lastname: Mario
authors.forename: Nicola
authors.initials: N
authors.lastname: Nicassio
authors.forename: Nicassio
authors.initials: N
authors.lastname: Nicola
authors.forename: Mauro
authors.initials: M
authors.lastname: Cambria
authors.forename: Cambria
authors.initials: C
authors.lastname: Mauro
keywords: Biphasic bleeding; cerebellopontine angle; intratumoral hemorrhage; patchy pattern; vestibular Schwannoma