Giant craniovertebral junction hemorrhagic schwannoma: case report.

OBJECTIVE: Schwannomas located at the crniovertebral junction are rare. Intratumoral microscopic bleeding may be a common finding, but an acute hemorrhagic presentation is an unusual occurrence. CLINICAL PRESENTATION: We report the case of a 44-year-old woman with acute onset of a hemorrhaic schwanoma of the C2nerve root. INTERVENTION: An emergency left far-lateral approach and a hemilaminectomy extending from C2 to C5 was performed. The tumor appeared as a dark-reddish sub-arachnoid mass. Tumor dissection and total removal were achieved by fragmentation and aspiration with an ultrasonic aspirator. A histological examination revealed a schwanoma with a hemorrhagic component. CONCLUSION: 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 considere when an acute onset of symptoms is present, even in patients without coagluopathies.