title: An unusual case of repeated intracranial hemorrhage in vestibular schwannoma.
abstract: BACKGROUND
  Symptomatic intratumoral hemorrhage (ITH) in vestibular schwannoma (VS) is rare. A repeated hemorrhage is, therefore, even more exceptional. Repeated ITH has been reported in four cases thus far in English literature. Here, we describe a patient with a Koos grade D VS who presented to our Skull Base team with repeated ITH and an unexpected disease course.
  
  
  METHODS
  A 76-year-old woman presented with hearing loss due to polycystic VS on the left side. Five years later, the patient was presented with facial palsy caused by hemorrhage in the VS. The patient had an eventful medical history that necessitated the use of anti-coagulants. The patient suffered from three subsequent hemorrhages preoperatively and one hemorrhage 36 h postoperatively.
  
  
  CONCLUSIONS
  We have experienced multiple repeated hemorrhages in a patient with a polycystic VS, and despite surgical intervention, the outcome was unfavorable.
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Debyelaan, The Netherlands.
authors.forename: Saeed
authors.initials: S
authors.lastname: Banaama
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Debyelaan, The Netherlands.
authors.forename: Jacobus
authors.initials: J
authors.lastname: van Overbeeke
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Debyelaan, The Netherlands.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Temel
keywords: Acoustic neuroma; repeated intratumoral hemorrhages; vestibular schwannoma