title: Cauda equina schwannoma presenting with intratumoral hemorrhage and intracranial subarachnoid hemorrhage.
abstract: The authors report the case of a spinal intradural schwannoma presenting with intracranial subarachnoid hemorrhage (SAH). Cerebral angiography did not show any intracranial lesion; however, MRI revealed two separate tumors in the lower segment of the spinal cord. The proximal lesion arising from the conus medullaris was well circumscribed and homogeneously enhanced, whereas the tumor in the cauda equina revealed hemorrhagic signals on MRI. This case also illustrates an unusual presentation of intracranial SAH simultaneously with intratumoral hemorrhage in a spinal cord schwannoma. The absence of hemorrhagic changes in the lesion arising proximal to the cauda equina region supports the mechanical theory proposed for the pathogenesis of hemorrhagic complications in spinal cord tumors.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kukreja
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D002420:Cauda Equina; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications* / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000150:complications* / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000601:surgery
keywords: SAH = subarachnoid hemorrhage; cauda equina; intratumoral hemorrhage; oncology; spinal cord schwannoma; subarachnoid hemorrhage