Case Report
BibTex RIS Cite

An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma

Year 2020, Volume: 4 Issue: 5, 420 - 422, 01.05.2020
https://doi.org/10.28982/josam.649652

Abstract

Vestibular schwannomas are relatively common benign tumors that account for 7-8% of all intracranial tumors. There is a limited number of cases of subarachnoid hemorrhage associated with vestibular schwannoma in the literature. The incidence of symptomatic tumor bleeding is historically reported less than 1%. Susceptibility-weighted imaging (SWI) is a relatively new Magnetic Resonance Imaging (MRI) sequence that is highly sensitive to compounds which distort the local magnetic field such as blood products and hemorrhage. We herein report the rare MRI findings of a 53-year-old man with unilateral vestibular schwannoma and hearing loss who was followed for 4 years. Initial diagnosis of the vestibular schwannoma was made on prior conventional MRI. We included SWI sequence in routine brain MRI protocol. During follow-up, SWI demonstrated focal superficial siderosis due to recurrent subarachnoid hemorrhage seen as hypointense blooming artifacts on the middle cerebellar peduncle-pons junction adjacent to the mass. We think that including SWI in routine MRI protocol will contribute to the initial diagnosis of acoustic schwannoma and detection of its complications such as subarachnoid hemorrhage and subsequent superficial siderosis.

References

  • 1. Mulkens TH, Parizel PM, Martin JJ, Degryse HR, Van de Heyning PH, Forton GE, et al. Acoustic schwannoma: MR findings in 84 tumors. AJR American Journal of Roentgenology. 1993;160(2):395-8. doi: 10.2214/ajr.160.2.8424360.
  • 2. Kim SH, Youm JY, Song SH, Kim Y, Song KS. Vestibular schwannoma with repeated intratumoral hemorrhage. Clinical Neurology and Neurosurgery. 1998;100(1):68-74. doi: 10.1016/s0303-8467(98)00002-x.
  • 3. Odabasi AO, Buchman CA, Morcos JJ. Tumor-associated hemorrhage in patients with acoustic neuroma. The American Journal of Otology. 2000;21(5):706-11.
  • 4. Misra BK, Rout D, Bhiladvala DB, Radhakrishnan V. Spontaneous haemorrhage in acoustic neurinomas. British Journal of Neurosurgery. 1995;9(2):219-21. doi: 10.1080/02688699550041593.
  • 5. Fearnley JM, Stevens JM, Rudge P. Superficial siderosis of the central nervous system. Brain: A Journal of Neurology. 1995;118(Pt 4):1051-66. doi: 10.1093/brain/118.4.1051.
  • 6. Glass B, Abbott KH. Subarachnoid hemorrhage consequent to intracranial tumors; review of literature and report of seven cases. AMA Archives of Neurology and Psychiatry. 1955;73(4):369-79. doi: 10.1001/archneurpsyc.1955.02330100001001.
  • 7. Locksley HB. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. Journal of Neurosurgery. 1966;25(2):219-39. doi: 10.3171/jns.1966.25.2.0219.
  • 8. Ohta S, Yokoyama T, Nishizawa S. Massive haemorrhage into acoustic neurinoma related to rapid growth of the tumour. British Journal of Neurosurgery. 1998;12(5):455-7. doi: 10.1080/02688699844709.
  • 9. Vellin JF, Bozorg Grayeli A, Kalamarides M, Fond C, Bouccara D, Sterkers O. Intratumoral and brainstem hemorrhage in a patient with vestibular schwannoma and oral anticoagulant therapy. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2006;27(2):209-12. doi: 10.1097/01.mao.0000188339.45772.be.
  • 10. Mishra A, Thomas B, Kapilamoorthy TR. Susceptibility weighted imaging - a problem-solving tool in differentiation of cerebellopontine angle schwannomas and meningiomas. Neuroradiol J. 2017;30(3):253-8. doi: 10.1177/1971400916689804.
  • 11. Fortnum H, O'Neill C, Taylor R, Lenthall R, Nikolopoulos T, Lightfoot G, et al. The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technology Assessment (Winchester, England). 2009;13(18):iii-iv, ix-xi, 1-154. doi: 10.3310/hta13180.
  • 12. Lin EP, Crane BT. The Management and Imaging of Vestibular Schwannomas. AJNR Am J Neuroradiol. 2017;38(11):2034-43. doi: 10.3174/ajnr.A5213.
  • 13. Gagliardo C, Martines F, Bencivinni F, La Tona G, Lo Casto A, Midiri M. Intratumoral haemorrhage causing an unusual clinical presentation of a vestibular schwannoma. Neuroradiol J. 2013;26(1):30-4. doi: 10.1177/197140091302600105.

Santral sinir sistemi yüzeyel siderozisin sıradışı bir nedeni: Vestibüler schwannoma olgusu

Year 2020, Volume: 4 Issue: 5, 420 - 422, 01.05.2020
https://doi.org/10.28982/josam.649652

Abstract

Vestibüler schwannomlar, tüm intrakranial tümörlerin %7-8'ini oluşturan nispeten yaygın görülen iyi huylu tümörlerdir. Literatürde vestibüler schwannoma ile ilişkili az sayıda subaraknoid kanama vakası vardır. Semptomatik tümör kanaması insidansı %1'den daha az olarak rapor edilmiştir. Duyarlılık ağırlıklı görüntüleme (DAG), kan ürünleri ve kanama gibi lokal manyetik alanı bozan bileşiklere karşı oldukça hassas olan yeni bir Manyetik Rezonans Görüntüleme (MRG) sekansıdır. Bu yazıda, 4 yıllık takipteki tek taraflı vestibüler schwannoma ve işitme kaybı olan 53 yaşında erkek hastanın nadir MRG bulgularını bildirmeyi amaçladık. Olgunun vestibüler schwannoma tanısı daha önceki konvansiyonel MRG bulguları ile koyuldu. Takipte kullanılan rutin MRG protokolüne DAG sekansını dahil ettik. Takip sırasında DAG, orta serebeller pedinkül-pons bileşkesinde kitle komşuluğunda hipointens artefaktlar şeklinde izlenen, rekürren subaraknoid kanamaya bağlı fokal yüzeyel sideroz odağını gösterdi. DAG’nin rutin beyin MRG protokolüne dahil edilmesinin, akustik schwannomanın ilk teşhisine, ayrıca subaraknoid kanama ve buna bağlı yüzeysel siderosis gibi komplikasyonların tespitine katkıda bulunacağını düşünüyoruz.

References

  • 1. Mulkens TH, Parizel PM, Martin JJ, Degryse HR, Van de Heyning PH, Forton GE, et al. Acoustic schwannoma: MR findings in 84 tumors. AJR American Journal of Roentgenology. 1993;160(2):395-8. doi: 10.2214/ajr.160.2.8424360.
  • 2. Kim SH, Youm JY, Song SH, Kim Y, Song KS. Vestibular schwannoma with repeated intratumoral hemorrhage. Clinical Neurology and Neurosurgery. 1998;100(1):68-74. doi: 10.1016/s0303-8467(98)00002-x.
  • 3. Odabasi AO, Buchman CA, Morcos JJ. Tumor-associated hemorrhage in patients with acoustic neuroma. The American Journal of Otology. 2000;21(5):706-11.
  • 4. Misra BK, Rout D, Bhiladvala DB, Radhakrishnan V. Spontaneous haemorrhage in acoustic neurinomas. British Journal of Neurosurgery. 1995;9(2):219-21. doi: 10.1080/02688699550041593.
  • 5. Fearnley JM, Stevens JM, Rudge P. Superficial siderosis of the central nervous system. Brain: A Journal of Neurology. 1995;118(Pt 4):1051-66. doi: 10.1093/brain/118.4.1051.
  • 6. Glass B, Abbott KH. Subarachnoid hemorrhage consequent to intracranial tumors; review of literature and report of seven cases. AMA Archives of Neurology and Psychiatry. 1955;73(4):369-79. doi: 10.1001/archneurpsyc.1955.02330100001001.
  • 7. Locksley HB. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. Journal of Neurosurgery. 1966;25(2):219-39. doi: 10.3171/jns.1966.25.2.0219.
  • 8. Ohta S, Yokoyama T, Nishizawa S. Massive haemorrhage into acoustic neurinoma related to rapid growth of the tumour. British Journal of Neurosurgery. 1998;12(5):455-7. doi: 10.1080/02688699844709.
  • 9. Vellin JF, Bozorg Grayeli A, Kalamarides M, Fond C, Bouccara D, Sterkers O. Intratumoral and brainstem hemorrhage in a patient with vestibular schwannoma and oral anticoagulant therapy. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2006;27(2):209-12. doi: 10.1097/01.mao.0000188339.45772.be.
  • 10. Mishra A, Thomas B, Kapilamoorthy TR. Susceptibility weighted imaging - a problem-solving tool in differentiation of cerebellopontine angle schwannomas and meningiomas. Neuroradiol J. 2017;30(3):253-8. doi: 10.1177/1971400916689804.
  • 11. Fortnum H, O'Neill C, Taylor R, Lenthall R, Nikolopoulos T, Lightfoot G, et al. The role of magnetic resonance imaging in the identification of suspected acoustic neuroma: a systematic review of clinical and cost effectiveness and natural history. Health Technology Assessment (Winchester, England). 2009;13(18):iii-iv, ix-xi, 1-154. doi: 10.3310/hta13180.
  • 12. Lin EP, Crane BT. The Management and Imaging of Vestibular Schwannomas. AJNR Am J Neuroradiol. 2017;38(11):2034-43. doi: 10.3174/ajnr.A5213.
  • 13. Gagliardo C, Martines F, Bencivinni F, La Tona G, Lo Casto A, Midiri M. Intratumoral haemorrhage causing an unusual clinical presentation of a vestibular schwannoma. Neuroradiol J. 2013;26(1):30-4. doi: 10.1177/197140091302600105.
There are 13 citations in total.

Details

Primary Language English
Subjects Radiology and Organ Imaging
Journal Section Case report
Authors

Bünyamin Güney 0000-0002-0853-4184

Yusuf Kenan Çetinoğlu 0000-0002-7878-6117

İbrahim Önder Yeniçeri 0000-0003-2779-2020

Neşat Çullu 0000-0002-5045-3919

Publication Date May 1, 2020
Published in Issue Year 2020 Volume: 4 Issue: 5

Cite

APA Güney, B., Çetinoğlu, Y. K., Yeniçeri, İ. Ö., Çullu, N. (2020). An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma. Journal of Surgery and Medicine, 4(5), 420-422. https://doi.org/10.28982/josam.649652
AMA Güney B, Çetinoğlu YK, Yeniçeri İÖ, Çullu N. An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma. J Surg Med. May 2020;4(5):420-422. doi:10.28982/josam.649652
Chicago Güney, Bünyamin, Yusuf Kenan Çetinoğlu, İbrahim Önder Yeniçeri, and Neşat Çullu. “An Unusual Cause of Superficial Siderosis of Central Nervous System: A Case Report of a Vestibular Schwannoma”. Journal of Surgery and Medicine 4, no. 5 (May 2020): 420-22. https://doi.org/10.28982/josam.649652.
EndNote Güney B, Çetinoğlu YK, Yeniçeri İÖ, Çullu N (May 1, 2020) An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma. Journal of Surgery and Medicine 4 5 420–422.
IEEE B. Güney, Y. K. Çetinoğlu, İ. Ö. Yeniçeri, and N. Çullu, “An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma”, J Surg Med, vol. 4, no. 5, pp. 420–422, 2020, doi: 10.28982/josam.649652.
ISNAD Güney, Bünyamin et al. “An Unusual Cause of Superficial Siderosis of Central Nervous System: A Case Report of a Vestibular Schwannoma”. Journal of Surgery and Medicine 4/5 (May 2020), 420-422. https://doi.org/10.28982/josam.649652.
JAMA Güney B, Çetinoğlu YK, Yeniçeri İÖ, Çullu N. An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma. J Surg Med. 2020;4:420–422.
MLA Güney, Bünyamin et al. “An Unusual Cause of Superficial Siderosis of Central Nervous System: A Case Report of a Vestibular Schwannoma”. Journal of Surgery and Medicine, vol. 4, no. 5, 2020, pp. 420-2, doi:10.28982/josam.649652.
Vancouver Güney B, Çetinoğlu YK, Yeniçeri İÖ, Çullu N. An unusual cause of superficial siderosis of central nervous system: A case report of a vestibular schwannoma. J Surg Med. 2020;4(5):420-2.