Giant craniovertebral junction hemorrhagic schwannoma: case report

Schwannomas located at the craniovertebral junction are rare. Intratumoral microscopic bleeding may be a common finding, but an acute hemorrhagic presentation is an unusual occurrence.

We report the case of a 44-year-old woman with acute onset of a hemorrhagic schwannoma of the C2 nerve root.

An emergency left far-lateral approach and a hemilaminectomy extending from C2 to C5 was performed. The tumor appeared as a dark-reddish subarachnoid mass. Tumor dissection and total removal were achieved by fragmentation and aspiration with an ultrasonic aspirator. A histological examination revealed a schwannoma with a hemorrhagic component.

Our case highlights the importance of early and proper management of the pathologies of the craniovertebral junction with acute onset. The suspicion of an intratumoral hemorrhagic event must be considered when an acute onset of symptoms is present, even in patients without coagulopathies.