A XXXX presenting with rapid neurologic decline: a case report.

@entity1 @entity129 @entity5513 @entity548 @entity1313 @entity1276 @entity510 @entity1274 @entity10
INTRODUCTION: @entity5513 ( @entity5513 ) account for approximately 8% of all @entity1313 and nearly 80% of @entity5513 . Spontaneous intratumoral @entity548 (ITH) remains a rare entity with only 10 published reports existing in the international literature. In the present case, we discuss the clinical presentation, radiographic evaluation and management of a 66-year-old male with a histologically confirmed spontaneous hemorrhagic @entity5513 . STUDY DESIGN: Case Report. SETTING: Tertiary referral center. RESULTS: A 66-year-old male with a history of prodromal left sided @entity1274 presented for evaluation after experiencing a rapid onset severe left sided @entity10 , projectile vomiting and vertigo that woke him from sleep. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a left sided 2 X 2 cm cerebellopontine angle mass consistent with a @entity5513 . Local mass effect resulted in 4th ventricle effacement and @entity1276 . Areas of T2 hypointensity and corresponding increased attenuation on CT confirmed an acute ITH. Hematology and coagulation laboratory studies were normal. The @entity1 subsequently underwent a left suboccipital craniotomy with complete resection of a histologically confirmed hemorrhagic @entity5513 . CONCLUSION: Spontaneous @entity548 into a @entity5513 is an extremely rare event. In contrast to the insidious progression typified by nonhemorrhagic VSs, those with gross intratumoral bleeding most often present with acute @entity129 and symptoms of @entity510 . In surgically fit @entity1 , we advocate urgent microsurgical resection. Simple observation with serial radiography may risk repeated @entity548 while the role of radiosurgery is not yet defined.
