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  • Title: Intratumoral and brainstem hemorrhage in a patient with vestibular schwannoma and oral anticoagulant therapy.
    Author: Vellin JF, Bozorg Grayeli A, Kalamarides M, Fond C, Bouccara D, Sterkers O.
    Journal: Otol Neurotol; 2006 Feb; 27(2):209-12. PubMed ID: 16436991.
    Abstract:
    OBJECTIVE: To report the first case of spontaneous intratumoral and brainstem hemorrhage in a patient with a vestibular schwannoma. STUDY DESIGN: Case report and review of the literature. SETTING: University-based, tertiary referral center. PATIENT: A 73-year-old woman with a vestibular schwannoma, anti-vitamin K overdose, and arterial hypertension experienced a rapid onset of headache, facial palsy, diplopia, and hoarseness. INTERVENTIONS: The patient was admitted to the intensive care unit and treated with vitamin K and corticoids. MAIN OUTCOME MEASURES: Clinical and radiologic findings. RESULTS: At admission, the magnetic resonance imaging and computed tomographic scans showed an intratumoral hemorrhage. The patient entered a coma 24 hours after the onset of the symptoms. At that time, the computed tomographic scan demonstrated a massive intratumoral and brainstem hemorrhage. The patient died 3 days later. CONCLUSION: Intratumoral, subarachnoid, and brainstem hemorrhages can occur in patients with vestibular schwannoma. Oral anticoagulant therapy is a risk factor for tumor-related hemorrhage.
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